MEDICARE: STUART BROWN PA-C

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	363AM0700X	Medical Physician Assistant	PA61614061	WA

General Provider Information

NPI Number	:	1871283523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STUART BROWN PA-C

Provider Business Mailing Address
First Line	:	1515 E COLUMBIA ST
Second Line	:
City	:	OTHELLO
State	:	WA
Zip	:	99344-1846
Country	:	US
Telephone Number	:	509-488-5256
Fax Number	:	509-488-9939

Provider Business Practice Location Address
First Line	:	6115 BURDEN BLVD STE D
Second Line	:
City	:	PASCO
State	:	WA
Zip	:	99301-0010
Country	:	US
Telephone Number	:	509-488-5256
Fax Number	:	509-488-9939

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

Provider Enumeration Date	:	05/08/2023
Last Update Date	:	10/25/2024

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Directions to “ STUART BROWN PA-C” Practice Location

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