Individual
BERHANU AYNALEM MEKBIB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9125 SW 55TH, EL DORADO, PORTLAND, OR 97266
(503) 771-1645
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
11/17/2014
Last updated
11/17/2014
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