Provider Demographics
NPI:1265049985
Name:BROWN, SKAIDRE ELENA (LM)
Entity type:Individual
Prefix:MRS
First Name:SKAIDRE
Middle Name:ELENA
Last Name:BROWN
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20800 HERMWAY HEIGHTS PL
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-8021
Mailing Address - Country:US
Mailing Address - Phone:360-421-5140
Mailing Address - Fax:
Practice Address - Street 1:20800 HERMWAY HEIGHTS PL
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-8021
Practice Address - Country:US
Practice Address - Phone:360-421-5140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-27
Last Update Date:2020-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMW61095935176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife