Individual
TADESSE KASSIE MELESSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
144 SW 20TH ST, PENDLETON, OR 97801-1804
(541) 278-5121
Mailing address
2201 NE 112TH AVE APT J87, VANCOUVER, WA 98684-4208
(202) 492-5041
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0017045
OR
Other
Enumeration date
05/04/2019
Last updated
05/04/2019
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