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Individual

MR. BERHANU KEBEDE BEDASSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PMHNP

Contact information

Practice address
13250 NE SHAVER ST, PORTLAND, OR 97230-1453
(213) 249-6973
Mailing address
13250 NE SHAVER ST, PORTLAND, OR 97230-1453
(213) 249-6973

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201606248RN
OR
163W00000X
Registered Nurse
RN61256180
WA
363LF0000X
Family Nurse Practitioner
95004776
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201707152NP-PP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP61370238
WA

Other

Enumeration date
08/24/2016
Last updated
11/01/2023
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