MEDICARE: AMBER BROWN LMP

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	225700000X	Massage Therapist	MA60322798	WA

General Provider Information

NPI Number	:	1558735548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER BROWN LMP

Provider Business Mailing Address
First Line	:	4257 KELLUM RANCH RD NW
Second Line	:
City	:	BREMERTON
State	:	WA
Zip	:	98312-9627
Country	:	US
Telephone Number	:	360-362-9620
Fax Number	:	360-443-6250

Provider Business Practice Location Address
First Line	:	2080 SE SEDGWICK RD
Second Line	:	SUITE 200
City	:	PORT ORCHARD
State	:	WA
Zip	:	98366-7003
Country	:	US
Telephone Number	:	360-602-0475
Fax Number	:	360-443-6250

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

Provider Enumeration Date	:	11/14/2015
Last Update Date	:	11/14/2015

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Directions to “ AMBER BROWN LMP” Practice Location

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