Provider Demographics
NPI:1811469315
Name:NIELSEN, BRANDON ELIAS
Entity type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:ELIAS
Last Name:NIELSEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 HIGHWAY 99 N
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-2404
Mailing Address - Country:US
Mailing Address - Phone:541-505-5684
Mailing Address - Fax:541-683-6196
Practice Address - Street 1:338 HIGHWAY 99 N
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-2404
Practice Address - Country:US
Practice Address - Phone:541-505-5684
Practice Address - Fax:541-683-6196
Is Sole Proprietor?:No
Enumeration Date:2018-12-20
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor