Individual
BRENT RICHARD NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1106 S COMMERCIAL WAY SE, ALBANY, OR 97322-7034
(503) 507-8710
Mailing address
PO BOX 1114, ALBANY, OR 97321-0534
(503) 507-8710
Taxonomy
Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
Primary
078408
OR
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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