Basic Information
| Provider Information | |||||||||
| NPI: | 1427454438 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | MELINDA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16259 SYLVESTER RD SW STE 401 | ||||||||
| Address2: | |||||||||
| City: | BURIEN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981663059 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2068231004 | ||||||||
| FaxNumber: | 2063093319 | ||||||||
| Practice Location | |||||||||
| Address1: | 16259 SYLVESTER RD SW STE 401 | ||||||||
| Address2: | |||||||||
| City: | BURIEN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981663059 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2068231004 | ||||||||
| FaxNumber: | 2063093319 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/18/2014 | ||||||||
| LastUpdateDate: | 05/13/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 51963 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | PA60865722 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.