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General NPI Number Information
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NPI Number | 1053616854
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Entity Type | Individual
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Provider Name | HIWOT BEKELE RPH
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Gender | Male
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Dates
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Enumeration Date | 01/26/2011
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Last Update Date | 03/15/2025
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Provider Practice Location Address
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Address Line | 16707 SE HAIG ST APT E101
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City | PORTLAND
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State | OR
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Zip | 97236-1421
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Country | US
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Telephone | 919-600-0436
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Fax |
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Provider Business Mailing Address
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Address Line | 16707 SE HAIG ST APT E101
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City | PORTLAND
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State | OR
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Zip | 97236-1421
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Country | US
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Telephone | 919-600-0436
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH0012512
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | MN
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