Healthcare Provider Details

I. General information

NPI: 1790872737
Provider Name (Legal Business Name): DANIEL F BROWN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12501 E MARGINAL WAY S STE 200
TUKWILA WA
98168-5163
US

IV. Provider business mailing address

12501 E MARGINAL WAY S STE 200
TUKWILA WA
98168-5163
US

V. Phone/Fax

Practice location:
  • Phone: 206-576-6050
  • Fax:
Mailing address:
  • Phone: 206-576-6050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZN0500X
TaxonomyNeuropathology Physician
License NumberMD068901L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207ZN0500X
TaxonomyNeuropathology Physician
License NumberMD61244982
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: