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1649048448
BRANDON KEITH LANE
PORTLAND, OR
NPI
1649048448
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2023-12-12
Last Update Date
2023-12-12
Business Address
BRANDON KEITH LANE
6828 SE HOLGATE BLVD
PORTLAND, OR 97206-3504
Phone number: 503-332-4969
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Mailing Address
BRANDON KEITH LANE
3804 N JUNEAU ST
PORTLAND, OR 97217-7427
Phone number:
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