Individual
HURUY KIDANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
945 NE 165TH AVE, PORTLAND, OR 97230-6148
(503) 408-8100
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
01/13/2014
Last updated
01/13/2014
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