Provider Demographics
NPI:1144394081
Name:BROWN, HOLLI (MT)
Entity Type:Individual
Prefix:
First Name:HOLLI
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3103 S SOMMER LN
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99037-8311
Mailing Address - Country:US
Mailing Address - Phone:509-994-1330
Mailing Address - Fax:509-892-6796
Practice Address - Street 1:3103 S SOMMER LN
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99037-8311
Practice Address - Country:US
Practice Address - Phone:509-994-1330
Practice Address - Fax:509-892-6796
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 19775174400000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No174400000XOther Service ProvidersSpecialist