Individual provider Active NPI

Debra D Brown, PHD

  • Clinical Neuropsychologist
  • Spokane, WA
National Provider Identifier
1225143654
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
2285 Issued in WA
Practice address
522 W Riverside Ave
Suite 710
Spokane, WA 99201-0504
Phone
(509) 242-2200
Fax
(509) 242-2202
NPI assigned
Aug 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 2285 WA Primary

Addresses

Primary practice location

522 W Riverside Ave
Suite 710
Spokane, WA 99201-0504

Mailing address

522 W Riverside Ave
Suite 710
Spokane, WA 99201-0504
Phone (509) 242-2200

Other identifiers 2

IdentifierTypeStateIssuer
0201860OtherWADEPT OF LABOR & INDUSTRIE
7101199MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051111000058 WA Practitioner - Clinical Psychologist 7012935737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1212 N Washington St
Suite 210
Spokane, WA 99201-2401
Phone (509) 242-2200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2285WAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Stacey Durland LMHC PLLC PastSince Dec 13, 2020 Accepting new patients
Cardiovascular Institute II, P.C. Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225143654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 W RIVERSIDE AVE",
            "address_2": "SUITE 710",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010504",
            "telephone_number": "509-242-2200",
            "fax_number": "509-242-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 W RIVERSIDE AVE",
            "address_2": "SUITE 710",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010504",
            "telephone_number": "509-242-2200",
            "fax_number": "509-242-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "DEBRA",
        "middle_name": "D",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "WA",
            "license": "2285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR & INDUSTRIE",
            "identifier": "0201860",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7101199",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.