Provider Demographics
NPI:1184895898
Name:BROWN, MARAYA KASOTA (CNM, MSN)
Entity type:Individual
Prefix:
First Name:MARAYA
Middle Name:KASOTA
Last Name:BROWN
Suffix:
Gender:F
Credentials:CNM, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2678 TAKELMA WAY
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-8612
Mailing Address - Country:US
Mailing Address - Phone:808-987-1082
Mailing Address - Fax:
Practice Address - Street 1:148 E HERSEY ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1359
Practice Address - Country:US
Practice Address - Phone:541-552-1111
Practice Address - Fax:541-482-9066
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201500851NP-PP367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife