Healthcare Provider Details

I. General information

NPI: 1649880287
Provider Name (Legal Business Name): KATHLEEN E BROWN APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2020
Last Update Date: 06/03/2022
Certification Date: 06/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 12TH AVE S
SEATTLE WA
98144-2712
US

IV. Provider business mailing address

1200 12TH AVE S
SEATTLE WA
98144-2712
US

V. Phone/Fax

Practice location:
  • Phone: 206-326-2400
  • Fax:
Mailing address:
  • Phone: 206-326-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberN361307344
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR199731
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: