Individual
BRANDON EXCELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
720 14TH AVE, LONGVIEW, WA 98632-2315
(360) 423-0203
(360) 577-0187
Mailing address
PO BOX 1847, LONGVIEW, WA 98632-8140
(360) 423-0203
(360) 577-0187
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CG61266843
—
WA
Enumeration date
02/07/2022
Last updated
02/07/2022
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