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1902300767
FITSUM N DEJENE
MILWAUKIE, OR
NPI
1902300767
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2018-03-19
Last Update Date
2018-03-19
Business Address
FITSUM N DEJENE
11458 SE MCEACHRON AVE
MILWAUKIE, OR 97222-1264
Phone number: 503-305-6296
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Mailing Address
FITSUM N DEJENE
3587 HEATHROW WAY
MEDFORD, OR 97504-4004
Phone number: 541-858-8170
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