Provider Demographics
NPI:1336303163
Name:BROWN, LYNEE JOANNE (SUDP)
Entity Type:Individual
Prefix:
First Name:LYNEE
Middle Name:JOANNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:SUDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 E. 8TH ST
Mailing Address - Street 2:PENINSULA BEHAVIORAL HEALTH
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362
Mailing Address - Country:US
Mailing Address - Phone:360-457-0431
Mailing Address - Fax:
Practice Address - Street 1:118 E 8TH ST
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-6129
Practice Address - Country:US
Practice Address - Phone:360-457-0431
Practice Address - Fax:360-452-2595
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
WACP60466472101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No174400000XOther Service ProvidersSpecialist