Individual
MISTIR MULATU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15065 SW OPAL DR, BEAVERTON, OR 97007-8770
(612) 414-1984
Mailing address
15065 SW OPAL DR, BEAVERTON, OR 97007-8770
(612) 414-1984
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
—
MN
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
05/03/2018
Last updated
05/03/2018
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