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General NPI Number Information
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NPI Number | 1578079554
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Entity Type | Individual
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Provider Name | LAUREN BROWN ATC
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Gender | Female
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Dates
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Enumeration Date | 12/28/2017
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Last Update Date | 12/28/2017
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Provider Practice Location Address
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Address Line | 1760 DOWN RIVER DR
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City | WOODLAND
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State | WA
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Zip | 98674-9699
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Country | US
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Telephone | 360-608-3883
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Fax |
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Provider Business Mailing Address
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Address Line | 29022 168TH AVE SE
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City | COVINGTON
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State | WA
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Zip | 98042-9435
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Country | US
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Telephone | 425-445-4209
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 60254661
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License Number State | WA
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