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Individual

BRENT LANNEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
9100 CENTENNIAL CIR, ANCHORAGE, AK 99504-1480
(907) 333-8100
Mailing address
25117 SW PARKWAY AVE, STE. D, WILSONVILLE, OR 97070-9697

Taxonomy

Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary

Other

Enumeration date
08/05/2014
Last updated
08/05/2014
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