Provider Demographics
NPI:1083628499
Name:BROWN, LORI ALBORN (MD)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ALBORN
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:LYNN
Other - Last Name:ALBORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 2292
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99342
Mailing Address - Country:US
Mailing Address - Phone:509-522-5815
Mailing Address - Fax:509-522-5818
Practice Address - Street 1:380 CHASE ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362
Practice Address - Country:US
Practice Address - Phone:509-525-8110
Practice Address - Fax:509-522-5743
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA41538207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8327421Medicaid
WA8327421Medicaid
WAAB33780Medicare ID - Type Unspecified