Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | AP60679795 | WA |
NPI | 1023562352 |
---|---|
Provider Name | Shawna Brown |
First Address | Aberdeen, WA 98520-2521 |
Second Address | Aberdeen, WA 98520-2521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2016 |
Last Update Date | 17/08/2021 |