Provider Demographics
NPI:1225329105
Name:BROWN, KAREN KRISTINE (MA)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:KRISTINE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 W DEAN AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-1825
Mailing Address - Country:US
Mailing Address - Phone:509-936-6360
Mailing Address - Fax:
Practice Address - Street 1:1624 W DEAN AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-1825
Practice Address - Country:US
Practice Address - Phone:509-939-6360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60309277101YM0800X
WAMC60207221101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1225329105Medicaid
WA2085712Medicaid