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General NPI Number Information
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NPI Number | 1174495626
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Entity Type | Individual
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Provider Name | TEMESGEN TERFASSA
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Gender | Male
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 8880 SE MANFIELD CT
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City | CLACKAMAS
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State | OR
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Zip | 97015-9565
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Country | US
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Telephone | 503-890-5513
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Fax | 503-206-6361
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Provider Business Mailing Address
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Address Line | 8880 SE MANFIELD CT
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City | CLACKAMAS
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State | OR
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Zip | 97015-9565
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Country | US
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Telephone | 503-890-5513
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Fax | 503-206-6361
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | OR
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