Individual
GEDIYON ETAFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1725 1ST ST, COLUMBIA CITY, OR 97018-9501
(510) 925-9014
Mailing address
1725 1ST ST, COLUMBIA CITY, OR 97018-9501
(510) 925-9014
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
6167878
OR
Other
Enumeration date
10/23/2025
Last updated
10/23/2025
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