Provider Demographics
NPI:1619316189
Name:BROWN, JAMES W (RVT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:W
Last Name:BROWN
Suffix:
Gender:M
Credentials:RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1306 50TH ST NE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-1215
Mailing Address - Country:US
Mailing Address - Phone:425-463-5477
Mailing Address - Fax:
Practice Address - Street 1:11714 N CREEK PKWY N STE 100
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-8250
Practice Address - Country:US
Practice Address - Phone:425-486-8868
Practice Address - Fax:425-486-8976
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA956212471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA95621OtherARDMS#