MEDICARE: CHERYLANN BROWN LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	LF00001891	WA

General Provider Information

NPI Number	:	1265565881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYLANN BROWN LMFT

Provider Business Mailing Address
First Line	:	6000 17TH AVE SW
Second Line	:	# 8
City	:	SEATTLE
State	:	WA
Zip	:	98106-3524
Country	:	US
Telephone Number	:	206-420-6146
Fax Number	:	855-287-0185

Provider Business Practice Location Address
First Line	:	3272 CALIFORNIA AVE SW
Second Line	:	#105
City	:	SEATTLE
State	:	WA
Zip	:	98116-3375
Country	:	US
Telephone Number	:	206-420-6146
Fax Number	:	855-287-0185

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	06/28/2019

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