Provider Demographics
NPI:1245601608
Name:DESPAIN-BROWN, LINDA (LMP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:DESPAIN-BROWN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10902
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98909-1902
Mailing Address - Country:US
Mailing Address - Phone:509-573-3700
Mailing Address - Fax:509-469-2286
Practice Address - Street 1:2117 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-2414
Practice Address - Country:US
Practice Address - Phone:509-573-3700
Practice Address - Fax:509-469-2286
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist