Organization
SOUL TO SOUL IHCA
Active
Other names
SOUL TO SOUL IHCA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEKEBO M YADETO DC (DIRECTOR)
(503) 915-3427
Entity
Organization
Contact information
Practice address
10612 SE 59TH AVE, MILWAUKIE, OR 97222-2701
(503) 342-6141
(503) 342-6217
Mailing address
10612 SE 59TH AVE, MILWAUKIE, OR 97222-2701
(503) 342-6141
(503) 342-6217
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1
—
OR
Enumeration date
01/07/2022
Last updated
01/07/2022
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