Individual
ROBERT IRWIN BROWN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNA
Contact information
Practice address
307 W COTA ST, SHELTON, WA 98584-2265
(503) 348-3767
Mailing address
910 SATSOP-CLOQUALLUM RD, ELMA, WA 98541
(360) 470-8168
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
NC60948068
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WDL2SNPDG93B
DRIVERS LICENSE
WA
Enumeration date
12/12/2019
Last updated
12/12/2019
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