Individual
TIBEBE WASSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5807 MAIN ST, SPRINGFIELD, OR 97478-6961
(541) 726-8423
(541) 726-8473
Mailing address
5807 MAIN ST, SPRINGFIELD, OR 97478-6961
(541) 726-8423
(541) 726-8473
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0014274
OR
Other
Enumeration date
09/24/2014
Last updated
09/24/2014
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