Healthcare Provider Details

I. General information

NPI: 1306764600
Provider Name (Legal Business Name): LILLIANNA BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E CENTRAL AVE
SPOKANE WA
99208-1108
US

IV. Provider business mailing address

2808 E EVERETT AVE APT 4
SPOKANE WA
99217-6216
US

V. Phone/Fax

Practice location:
  • Phone: 509-599-9773
  • Fax:
Mailing address:
  • Phone: 509-599-9773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberCBT.CB.70149013
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: