Organization
LIGHT RESIDENTIAL SERVICE LLC
Active
Other names
Light Residential Service LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MULUSEW GETIE KEBTIE RN, BSN, MSC (DIRECTOR)
(301) 633-9649
Entity
Organization
Contact information
Practice address
16730 BUCKINGHAM DR, GLADSTONE, OR 97027-1044
(301) 633-9649
(503) 344-6669
Mailing address
16730 BUCKINGHAM DR, GLADSTONE, OR 97027-1044
(301) 633-9649
(503) 344-6669
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
Other
Enumeration date
11/22/2022
Last updated
11/22/2022
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