Healthcare Provider Details

I. General information

NPI: 1104482942
Provider Name (Legal Business Name): TRISTIN ANN BROWN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2019
Last Update Date: 05/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1406 ROCK ISLAND RD
EAST WENATCHEE WA
98802-5681
US

IV. Provider business mailing address

1230 MONITOR ST
WENATCHEE WA
98801-3534
US

V. Phone/Fax

Practice location:
  • Phone: 506-860-4919
  • Fax:
Mailing address:
  • Phone: 509-300-1221
  • Fax: 506-663-4637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberRN60121937
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: