Provider Demographics
NPI:1841406006
Name:BROWN, PHILIP MICHAEL (MA, MSW, PHD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:MICHAEL
Last Name:BROWN
Suffix:
Gender:M
Credentials:MA, MSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:793 ERICKSEN AVE NE
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-1876
Mailing Address - Country:US
Mailing Address - Phone:206-853-6852
Mailing Address - Fax:206-855-8864
Practice Address - Street 1:793 ERICKSEN AVE NE
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-1876
Practice Address - Country:US
Practice Address - Phone:206-853-6852
Practice Address - Fax:206-855-8864
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC000041961041C0700X
WALW000078011041C0700X
WALF00002411106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist