Individual
JEAN M BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2500 NE NEFF RD, BEND, OR 97701-6015
(541) 388-1636
(541) 388-1719
Mailing address
PO BOX 5579, BEND, OR 97708-5579
(541) 388-1636
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
569-023
WI
363A00000X
Physician Assistant
Primary
PA01237
OR
363AS0400X
Surgical Physician Assistant
569-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00834460
MEDICARE RAILROAD
OR
01
—
2908
DEAN HEALTH INSURANCE
WI
05
—
42923300
—
WI
05
—
500605405
—
OR
01
—
970010935
RAILROAD MEDICARE
WI
Enumeration date
05/01/2006
Last updated
06/01/2015
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