Provider Demographics
NPI:1851346506
Name:BROWN, KATHERINE ANN (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:ANN
Other - Last Name:BLODGETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:201 16TH AVE E
Mailing Address - Street 2:CMB 140
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-5226
Mailing Address - Country:US
Mailing Address - Phone:206-326-3609
Mailing Address - Fax:206-326-3603
Practice Address - Street 1:201 16TH AVE E
Practice Address - Street 2:CMB 140
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5226
Practice Address - Country:US
Practice Address - Phone:206-326-3609
Practice Address - Fax:206-326-3603
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2013-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8628207R00000X
WAMD60066941207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8553539Medicaid
H19086Medicare UPIN
TX8C1370Medicare PIN