Individual
BERHAN KIDANE TEKLETSION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10800 NE 109TH AVE, VANCOUVER, WA 98662-3371
(571) 665-9250
Mailing address
10800 NE 109TH AVE, VANCOUVER, WA 98662-3371
(571) 665-9250
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN00154055
WA
Other
Enumeration date
12/07/2022
Last updated
12/07/2022
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