MEDICARE: MR. BRENT J ROWE MD

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	208600000X	Surgery Physician	MD00038372	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1126R0	OTHER		REGENCE WA
3	140415	OTHER	WA	DEPT OF L & I

General Provider Information

NPI Number	:	1467449967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRENT J ROWE MD

Provider Business Mailing Address
First Line	:	954 ANDERSON DR
Second Line	:
City	:	ABERDEEN
State	:	WA
Zip	:	98520-1001
Country	:	US
Telephone Number	:	360-532-1360
Fax Number	:	360-532-6878

Provider Business Practice Location Address
First Line	:	954 ANDERSON DR
Second Line	:
City	:	ABERDEEN
State	:	WA
Zip	:	98520-1001
Country	:	US
Telephone Number	:	360-532-1360
Fax Number	:	360-532-6878

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

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	10/01/2012

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Directions to “ MR. BRENT J ROWE MD” Practice Location

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