Healthcare Provider Details

I. General information

NPI: 1881171171
Provider Name (Legal Business Name): CHRISTA LYNN BROWN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2018
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 S OTHELLO ST
SEATTLE WA
98118-3510
US

IV. Provider business mailing address

2635 34TH AVE W
SEATTLE WA
98199-3224
US

V. Phone/Fax

Practice location:
  • Phone: 206-788-3547
  • Fax:
Mailing address:
  • Phone: 206-498-5015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60800325
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: