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1205001526
BRANDON ELLIS
PORTLAND, OR
NPI
1205001526
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: OR 12645)
Enumeration Date
2008-04-28
Last Update Date
2008-04-28
Business Address
Mr. BRANDON ELLIS LMT
7085 N CAMBRIDGE AVE
PORTLAND, OR 97203-4715
Phone number: 503-285-6320
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Mailing Address
Mr. BRANDON ELLIS LMT
7085 N CAMBRIDGE AVE
PORTLAND, OR 97203-4715
Phone number: 503-285-6320
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