Healthcare Provider Details

I. General information

NPI: 1568458842
Provider Name (Legal Business Name): BRENT ARLISS FRANCISCO ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 BROADWAY ST
LONGVIEW WA
98632-3256
US

IV. Provider business mailing address

PO BOX 3002
LONGVIEW WA
98632-0302
US

V. Phone/Fax

Practice location:
  • Phone: 360-414-2236
  • Fax: 360-414-2788
Mailing address:
  • Phone: 360-414-2048
  • Fax: 360-575-6749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN00067793
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP30005807
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: