Provider Demographics
NPI:1942859137
Name:BROWN, CALEY (LDM)
Entity Type:Individual
Prefix:
First Name:CALEY
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:LDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4711 NE 60TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97218-2610
Mailing Address - Country:US
Mailing Address - Phone:406-212-2048
Mailing Address - Fax:
Practice Address - Street 1:4711 NE 60TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97218-2610
Practice Address - Country:US
Practice Address - Phone:406-212-2048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDEM-LD-10202681176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife