Individual
TIRSTE WOSENU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3056 NE 127TH AVE, PORTLAND, OR 97230-1621
(614) 684-8672
(503) 386-2242
Mailing address
3056 NE 127TH AVE, PORTLAND, OR 97230-1621
(614) 684-8672
(503) 386-2242
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
DZ1494
OR
Other
Enumeration date
02/15/2024
Last updated
02/15/2024
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