Provider Demographics
NPI:1689792400
Name:BROWN, BARBARA J (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:J
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12805 NE 190TH PL
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-3129
Mailing Address - Country:US
Mailing Address - Phone:425-736-7882
Mailing Address - Fax:
Practice Address - Street 1:12805 NE 190TH PL
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-3129
Practice Address - Country:US
Practice Address - Phone:425-736-7882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000041421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1841647609OtherGROUP NPI
WAG8927814Medicare PIN