Healthcare Provider Details

I. General information

NPI: 1740300714
Provider Name (Legal Business Name): JAMILA M BROWN PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5224 WILSON AVE S SUITE 202
SEATTLE WA
98118-2587
US

IV. Provider business mailing address

1752 NW MARKET ST # 4512
SEATTLE WA
98107-5264
US

V. Phone/Fax

Practice location:
  • Phone: 206-725-1820
  • Fax: 206-725-1890
Mailing address:
  • Phone: 206-800-8396
  • Fax: 206-299-0429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY00003705
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPY00003705
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: