Provider Demographics
NPI:1144228750
Name:BROWN, ALAN BURCHARD (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:BURCHARD
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5845
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97228-5845
Mailing Address - Country:US
Mailing Address - Phone:425-462-9800
Mailing Address - Fax:425-454-9143
Practice Address - Street 1:1427 116TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3807
Practice Address - Country:US
Practice Address - Phone:425-462-9800
Practice Address - Fax:425-454-9143
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00027055207XS0117X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8116857Medicaid
G8960873Medicare PIN
WA8116857Medicaid