Healthcare Provider Details

I. General information

NPI: 1225143654
Provider Name (Legal Business Name): DEBRA D BROWN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 W RIVERSIDE AVE SUITE 710
SPOKANE WA
99201-0504
US

IV. Provider business mailing address

522 W RIVERSIDE AVE SUITE 710
SPOKANE WA
99201-0504
US

V. Phone/Fax

Practice location:
  • Phone: 509-242-2200
  • Fax: 509-242-2202
Mailing address:
  • Phone: 509-242-2200
  • Fax: 509-242-2202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number2285
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: