Provider Demographics
NPI:1588999437
Name:MCDOWELL, BRISA FLORENCE (LMP)
Entity type:Individual
Prefix:MS
First Name:BRISA
Middle Name:FLORENCE
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 CASCADE LN
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-2912
Mailing Address - Country:US
Mailing Address - Phone:206-458-9952
Mailing Address - Fax:
Practice Address - Street 1:7935 216TH ST SW
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7941
Practice Address - Country:US
Practice Address - Phone:425-672-2113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-10
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60113993174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist