Provider Demographics
NPI:1679616197
Name:BROWN, PATRICIA J (MSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:J
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSW
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 87
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-0087
Mailing Address - Country:US
Mailing Address - Phone:503-472-2985
Mailing Address - Fax:503-876-7693
Practice Address - Street 1:1027 NE 3RD ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-4417
Practice Address - Country:US
Practice Address - Phone:503-472-2985
Practice Address - Fax:503-876-7693
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR00-07-03101YA0400X
OR41511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)