Healthcare Provider Details

I. General information

NPI: 1568614931
Provider Name (Legal Business Name): JONATHAN RAY BROWN MA, LH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2008
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 NW GILMAN BLVD STE 308
ISSAQUAH WA
98027-2549
US

IV. Provider business mailing address

160 NW GILMAN BLVD STE 308
ISSAQUAH WA
98027-2549
US

V. Phone/Fax

Practice location:
  • Phone: 425-395-4340
  • Fax:
Mailing address:
  • Phone: 425-395-4340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10003579
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60428138
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLH60428138
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: