MEDICARE: SHAWN JV BROW CRNA

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	367500000X	Certified Registered Nurse Anesthetist	AP30001992	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

General Provider Information

NPI Number	:	1760592596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWN JV BROW CRNA

Provider Business Mailing Address
First Line	:	PO BOX 30306
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99223-3005
Country	:	US
Telephone Number	:	509-939-6069
Fax Number	:	509-228-9542

Provider Business Practice Location Address
First Line	:	526 N MULLAN RD STE A
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-2407
Country	:	US
Telephone Number	:	509-924-2600
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	12/19/2016

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