Provider Demographics
NPI:1437924248
Name:BROWN, DENISE MARY (CHW)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:MARY
Last Name:BROWN
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3114 SYKES CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ROGUE RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97537-9772
Mailing Address - Country:US
Mailing Address - Phone:541-787-5322
Mailing Address - Fax:
Practice Address - Street 1:500 MONROE ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-3522
Practice Address - Country:US
Practice Address - Phone:541-261-6755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR109967171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator