MEDICARE: MRS. JASMINE L. BLAIR-BROWN M.ED., LMHC

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	101YM0800X	Mental Health Counselor	LH60827672	WA

General Provider Information

NPI Number	:	1518206770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JASMINE L. BLAIR-BROWN M.ED., LMHC

Provider Business Mailing Address
First Line	:	616 6TH ST
Second Line	:
City	:	BREMERTON
State	:	WA
Zip	:	98337-1420
Country	:	US
Telephone Number	:	360-377-3776
Fax Number	:	360-373-2096

Provider Business Practice Location Address
First Line	:	9330 59TH AVE SW
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-2858
Country	:	US
Telephone Number	:	253-581-7020
Fax Number	:	253-584-7852

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

Provider Enumeration Date	:	02/07/2013
Last Update Date	:	03/30/2020

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