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General NPI Number Information
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NPI Number | 1861683617
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Entity Type | Individual
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Provider Name | JENNIFER MARIE BROWN M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 02/10/2022
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Provider Practice Location Address
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Address Line | 1639 SE ENSIGN LN STE B103
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City | WARRENTON
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State | OR
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Zip | 97146-7308
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Country | US
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Telephone | 503-338-4500
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Fax | 503-338-4501
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Provider Business Mailing Address
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Address Line | 2925 CHICAGO AVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55407-1321
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 50777
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License Number State | OR
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