Provider Demographics
NPI:1649873126
Name:BROWN, TRENT ALLEN (BS, RCIS)
Entity type:Individual
Prefix:
First Name:TRENT
Middle Name:ALLEN
Last Name:BROWN
Suffix:
Gender:M
Credentials:BS, RCIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 WATERS EDGE CT
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:WI
Mailing Address - Zip Code:53559-8979
Mailing Address - Country:US
Mailing Address - Phone:608-852-5580
Mailing Address - Fax:
Practice Address - Street 1:9040 JACKSON AVE ATTN: MCHJ-CLQ-C
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-0001
Practice Address - Country:US
Practice Address - Phone:253-968-0847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No246XC2901XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularCardiovascular Invasive Specialist