Provider Demographics
NPI:1558611871
Name:BROWN, BEVERLY ALANA (OD)
Entity Type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:ALANA
Last Name:BROWN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 NE 67TH ST APT 7
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-5696
Mailing Address - Country:US
Mailing Address - Phone:863-838-9292
Mailing Address - Fax:
Practice Address - Street 1:17601 140TH AVE NE STE 200
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-6824
Practice Address - Country:US
Practice Address - Phone:425-483-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002158152W00000X
WA60726616152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist