Provider Demographics
NPI:1861541310
Name:BROWN, KEITH A (MD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:A
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15121 NE 177TH DR
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-6251
Mailing Address - Country:US
Mailing Address - Phone:425-488-9023
Mailing Address - Fax:
Practice Address - Street 1:2704 I ST NE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-2411
Practice Address - Country:US
Practice Address - Phone:253-833-7444
Practice Address - Fax:253-833-0480
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000248522084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry