Provider Demographics
NPI:1760823900
Name:BROWN, ANDREW SHIELDS (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:SHIELDS
Last Name:BROWN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:1211 SKYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-1099
Mailing Address - Country:US
Mailing Address - Phone:360-532-3808
Mailing Address - Fax:360-533-4884
Practice Address - Street 1:3300 GALLOWS RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3307
Practice Address - Country:US
Practice Address - Phone:703-776-4001
Practice Address - Fax:703-776-7113
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT055-0031643363A00000X
WYPA662363A00000X
WAPA60485019363A00000X
WA390200000X
VA0110008975363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program