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General NPI Number Information
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NPI Number | 1891409546
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Entity Type | Individual
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Provider Name | PAYTON BROWN LMT
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Gender | Female
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Dates
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Enumeration Date | 01/09/2023
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 17090 AVONDALE WAY NE
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City | REDMOND
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State | WA
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Zip | 98052-4409
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Country | US
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Telephone | 425-780-7208
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Fax | 425-888-1273
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Provider Business Mailing Address
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Address Line | 827 MILLS PL NE
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City | NORTH BEND
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State | WA
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Zip | 98045-9440
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Country | US
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Telephone | 425-780-7208
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Fax | 425-888-1273
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA61367488
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License Number State | WA
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