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Individual

FELASFAW MULUGETA DEGEFU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1599 NW TOWLE TER, GRESHAM, OR 97030-3655
(612) 772-7178
Mailing address
1599 NW TOWLE TER, GRESHAM, OR 97030-3655

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary

Other

Enumeration date
09/18/2025
Last updated
09/18/2025
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