Basic Information
| Provider Information | |||||||||
| NPI: | 1790378255 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | BRITTNEY | ||||||||
| MiddleName: | CHRISTINA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21 WAVERLY ST UNIT 2 | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | ME | ||||||||
| PostalCode: | 041033313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606336326 | ||||||||
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| Practice Location | |||||||||
| Address1: | 616 6TH ST | ||||||||
| Address2: | |||||||||
| City: | BREMERTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983371420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603773776 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2021 | ||||||||
| LastUpdateDate: | 02/16/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | WA | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.