TIGIST Y FANTAYE

PORTLAND, OR
NPI1689209504
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Additional Taxonomies163W00000X Registered Nurse
(Licence: OR  201906814RN)
Enumeration Date2020-03-11
Last Update Date2020-03-11
Business Address
TIGIST Y FANTAYE
4212 SE DIVISION ST STE 100
PORTLAND, OR 97206-1680
Phone number: 503-238-0705
Mailing Address
TIGIST Y FANTAYE
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number: