Individual
MR. HABTEMARIAM KETEMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16215 SE WEBSTER RD, MILWAUKIE, OR 97267-5254
(503) 353-7608
(503) 744-0178
Mailing address
16215 SE WEBSTER RD, MILWAUKIE, OR 97267-5254
(503) 353-7608
(503) 744-0178
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
526141-C
OR
Other
Enumeration date
07/11/2017
Last updated
07/11/2017
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