Healthcare Provider Details

I. General information

NPI: 1417632803
Provider Name (Legal Business Name): AMI MICHELLE BROWN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 140TH AVE NE STE 200
BELLEVUE WA
98005-4500
US

IV. Provider business mailing address

8120 SE 77TH PL
MERCER ISLAND WA
98040-5937
US

V. Phone/Fax

Practice location:
  • Phone: 425-736-9933
  • Fax:
Mailing address:
  • Phone: 425-736-9933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP61453072
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: