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Individual

ASEFA TEREFE WUBNEH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
16625 NE EVERETT CT, PORTLAND, OR 97230-6243
(503) 997-5469
Mailing address
16625 NE EVERETT CT, PORTLAND, OR 97230-6243
(503) 997-5469

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
DZ186034
OR

Other

Enumeration date
12/15/2025
Last updated
12/15/2025
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