Individual
ABDISSA EDAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
3640 SE 144TH AVE, PORTLAND, OR 97236-2729
(503) 679-2918
Mailing address
3708 SE 144TH AVE, PORTLAND, OR 97236-2731
(503) 679-2918
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
202108371LPN
OR
Other
Enumeration date
06/23/2022
Last updated
06/23/2022
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