Provider Demographics
NPI:1760826366
Name:BROWN, DAVID KENNETH
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:KENNETH
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 SE 7TH AVE
Mailing Address - Street 2:SUITE 4450
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4157
Mailing Address - Country:US
Mailing Address - Phone:503-352-2668
Mailing Address - Fax:
Practice Address - Street 1:333 SE 7TH AVE
Practice Address - Street 2:SUITE 4450
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4157
Practice Address - Country:US
Practice Address - Phone:503-352-2668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-25
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR30768231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist