Provider Demographics
NPI:1629015789
Name:BROWN, LINDA R (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:R
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 24TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-2592
Mailing Address - Country:US
Mailing Address - Phone:360-293-2020
Mailing Address - Fax:360-299-0341
Practice Address - Street 1:1213 24TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-2592
Practice Address - Country:US
Practice Address - Phone:360-293-2020
Practice Address - Fax:360-299-0341
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAM000027694207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0031987OtherL & I
WA1058288Medicaid
0031987OtherL & I
001145171Medicare ID - Type Unspecified