Provider Demographics
NPI:1669478988
Name:BROWN, SHERYL RUTH (LMFT)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:RUTH
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2333
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-0105
Mailing Address - Country:US
Mailing Address - Phone:425-652-1413
Mailing Address - Fax:425-313-0935
Practice Address - Street 1:22525 SE 64TH PL
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5383
Practice Address - Country:US
Practice Address - Phone:425-652-1413
Practice Address - Fax:425-313-0935
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF 00001856106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist