Individual
BRANDI ELISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
14815 SE DIVISION ST, PORTLAND, OR 97236-2336
(503) 595-2749
Mailing address
14314 SE 16TH CIR, VANCOUVER, WA 98683-7546
(503) 595-2743
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L3595
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L3595
LCSW
OR
Enumeration date
02/02/2007
Last updated
11/06/2024
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