Provider Demographics
NPI:1427458660
Name:BROWN, JENNIE (DNP, ARNP)
Entity type:Individual
Prefix:
First Name:JENNIE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:DNP, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8301 161ST AVE NE STE 202
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3858
Mailing Address - Country:US
Mailing Address - Phone:425-892-5549
Mailing Address - Fax:
Practice Address - Street 1:75 NW DOGWOOD ST STE B
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-3258
Practice Address - Country:US
Practice Address - Phone:425-269-3277
Practice Address - Fax:425-391-1484
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60495202363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health