Provider Demographics
NPI:1225186828
Name:BROWN, KERI (MD)
Entity Type:Individual
Prefix:
First Name:KERI
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KERI LI
Other - Middle Name:MOMI KIYOTOKI
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:222 STATE AVE N
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-4544
Mailing Address - Country:US
Mailing Address - Phone:253-372-7849
Mailing Address - Fax:
Practice Address - Street 1:222 STATE AVE N
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-4544
Practice Address - Country:US
Practice Address - Phone:253-372-7849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMDR 4351207V00000X
WAMD00048361207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology