MEDICARE: DR. JAMILA M BROWN PSYD

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	103TC0700X	Clinical Psychologist	PY00003705	WA
2	103TC2200X	Clinical Child & Adolescent Psychologist	PY00003705	WA

General Provider Information

NPI Number	:	1740300714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMILA M BROWN PSYD

Provider Business Mailing Address
First Line	:	1752 NW MARKET ST # 4512
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-5264
Country	:	US
Telephone Number	:	206-800-8396
Fax Number	:	206-299-0429

Provider Business Practice Location Address
First Line	:	5224 WILSON AVE S
Second Line	:	SUITE 202
City	:	SEATTLE
State	:	WA
Zip	:	98118-2587
Country	:	US
Telephone Number	:	206-725-1820
Fax Number	:	206-725-1890

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

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	11/15/2022

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