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1801403910
BASETI GELGELU
PORTLAND, OR
NPI
1801403910
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
311ZA0620X Custodial Care Facility, Adult Care Home
(Licence: OR 525603)
Enumeration Date
2020-09-23
Last Update Date
2020-09-23
Business Address
BASETI GELGELU
2055 SW 79TH AVE
PORTLAND, OR 97225-3805
Phone number: 206-306-3730
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Mailing Address
BASETI GELGELU
2055 SW 79TH AVE
PORTLAND, OR 97225-3805
Phone number: 206-306-3730
Copy
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