Individual
SHENISE BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3209 S 23RD ST, SUITE 340, TACOMA, WA 98405-1602
(253) 272-5127
(253) 272-0811
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
AP60237680
WA
367500000X
Certified Registered Nurse Anesthetist
Primary
NA95000943
CA
367500000X
Certified Registered Nurse Anesthetist
RN569289
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2017770
—
WA
01
—
G8955650
MDCR PTAN (K)
WA
01
—
G8960892
MDCR PTAN (P)
WA
Enumeration date
09/16/2009
Last updated
10/25/2021
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