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General NPI Number Information
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NPI Number | 1235198805
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Entity Type | Individual
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Provider Name | KATIE E. BREWER PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/21/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 17336 PICKWICK DR
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City | PURCELLVILLE
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State | VA
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Zip | 20132-6179
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Country | US
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Telephone | 540-338-3360
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Fax |
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Provider Business Mailing Address
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Address Line | 5920 100TH ST SW STE 26
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City | LAKEWOOD
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State | WA
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Zip | 98499-2751
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Country | US
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Telephone | 253-588-0756
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Fax | 253-581-3787
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0110004413
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License Number State | VA
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