Provider Demographics
NPI:1942359799
Name:BROWN, KATHERINE LYNN (MD, MPH)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LYNN
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 PACIFIC AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98337-1903
Mailing Address - Country:US
Mailing Address - Phone:360-782-1700
Mailing Address - Fax:
Practice Address - Street 1:555 PACIFIC AVE STE 202
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98337-1903
Practice Address - Country:US
Practice Address - Phone:360-782-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-02298207N00000X
MA229815207N00000X
FLME111829207N00000X
VA0101254768207N00000X
WAMD60788108207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFY310YMedicare PIN