Basic Information
Provider Information
NPI: 1952377335
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROWN
FirstName: KATHERINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1145 BROADWAY
Address2:  
City: SEATTLE
State: WA
PostalCode: 981224201
CountryCode: US
TelephoneNumber: 2063291760
FaxNumber:  
Practice Location
Address1: 509 OLIVE WAY
Address2: SUITE 900
City: SEATTLE
State: WA
PostalCode: 981011720
CountryCode: US
TelephoneNumber: 2068604700
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/27/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XMD00032093WAY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
109843305WA MEDICAID


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