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Individual
FEYISSA JAFAR WAGESSO
Active
Individual
FEYISSA JAFAR WAGESSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A636435500
—
MN
Enumeration date
07/03/2024
Last updated
08/08/2025
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