Individual
EYERUSALEM WOLDU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12684 SE MAJESTIC LN, HAPPY VALLEY, OR 97086-9313
(769) 447-7780
Mailing address
445 E BERKELEY ST, GLADSTONE, OR 97027-2419
(769) 447-7780
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
OR
Other
Enumeration date
09/03/2025
Last updated
09/03/2025
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