Organization
BENEPRO P.C.
Active
Other names
Marina Medical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL C BROWN M.D. (OWNER)
(206) 878-8600
Entity
Organization
Contact information
Practice address
22236 7TH AVE S, DES MOINES, WA 98198-6220
(206) 878-8600
(206) 878-4001
Mailing address
22236 7TH AVE S, DES MOINES, WA 98198-6220
(206) 878-8600
(206) 878-4001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5607MA
WA BLUE SHEILD
WA
01
—
DD4023
RAILROAD
WA
Enumeration date
06/25/2007
Last updated
10/29/2007
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