Provider Demographics
NPI:1174652531
Name:BROWN, CATHY LYNNE (MC)
Entity Type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:LYNNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21014 SNAG ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:LAKE TAPPS
Mailing Address - State:WA
Mailing Address - Zip Code:98391-8702
Mailing Address - Country:US
Mailing Address - Phone:253-874-3855
Mailing Address - Fax:
Practice Address - Street 1:33710 9TH AVE S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6734
Practice Address - Country:US
Practice Address - Phone:253-874-3855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005579101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health