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General NPI Number Information
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NPI Number | 1306793914
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Entity Type | Individual
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Provider Name | BRAYDEN BROWN
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Gender | Male
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Dates
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Enumeration Date | 03/12/2026
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Last Update Date | 03/12/2026
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Provider Practice Location Address
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Address Line | 417 E PIONEER STE B
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City | PUYALLUP
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State | WA
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Zip | 98372-3267
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Country | US
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Telephone | 425-298-3128
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Fax |
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Provider Business Mailing Address
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Address Line | 8411 229TH STREET CT E
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City | GRAHAM
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State | WA
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Zip | 98338-6540
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Country | US
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Telephone | 253-381-1217
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | CAAR.CG.70029774
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License Number State | WA
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