Provider Demographics
NPI:1750471843
Name:BROWN, CHRISTINE RACELY (ARNP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:RACELY
Last Name:BROWN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 W COURT ST
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-2776
Mailing Address - Country:US
Mailing Address - Phone:866-904-7721
Mailing Address - Fax:
Practice Address - Street 1:123 E INDIANA AVE
Practice Address - Street 2:STE 100
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-2313
Practice Address - Country:US
Practice Address - Phone:866-904-7721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30001087367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
S54571Medicare UPIN