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1346707296
DASTU I AHMAT
GRESHAM, OR
NPI
1346707296
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
311ZA0620X Custodial Care Facility, Adult Care Home
(Licence: OR 11146)
Enumeration Date
2019-02-27
Last Update Date
2019-02-27
Business Address
DASTU I AHMAT
55 NW 23RD ST
GRESHAM, OR 97030-2640
Phone number: 503-984-6216
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Mailing Address
DASTU I AHMAT
55 NW 23RD ST
GRESHAM, OR 97030-2640
Phone number: 503-984-6216
Copy