Provider Demographics
NPI:1225143654
Name:BROWN, DEBRA D (PHD)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:D
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 W RIVERSIDE AVE
Mailing Address - Street 2:SUITE 710
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-0504
Mailing Address - Country:US
Mailing Address - Phone:509-242-2200
Mailing Address - Fax:509-242-2202
Practice Address - Street 1:522 W RIVERSIDE AVE
Practice Address - Street 2:SUITE 710
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-0504
Practice Address - Country:US
Practice Address - Phone:509-242-2200
Practice Address - Fax:509-242-2202
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2285103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7101199Medicaid
WA0201860OtherDEPT OF LABOR & INDUSTRIE
WAS59849Medicare UPIN
WA0201860OtherDEPT OF LABOR & INDUSTRIE