Provider Demographics
NPI:1053462135
Name:BROWN, KATHERINE ANN (MD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 NE ARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-2611
Mailing Address - Country:US
Mailing Address - Phone:503-693-0113
Mailing Address - Fax:503-681-4773
Practice Address - Street 1:1575 NE ARRINGTON RD
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-2611
Practice Address - Country:US
Practice Address - Phone:503-693-0113
Practice Address - Fax:503-681-4773
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD19889207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR081869Medicaid
ORE78965Medicare UPIN
OR0000BLBZMMedicare ID - Type Unspecified