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General NPI Number Information
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NPI Number | 1700461928
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Entity Type | Individual
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Provider Name | MOHAMMED WOYESSO TESHITE PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 03/10/2021
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Last Update Date | 03/10/2021
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Provider Practice Location Address
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Address Line | 629 HIGHWAY 20 N
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City | HINES
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State | OR
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Zip | 97738-9435
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Country | US
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Telephone | 541-573-1523
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Fax |
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Provider Business Mailing Address
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Address Line | 460 NE BELLEVUE DR APT 209
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City | BEND
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State | OR
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Zip | 97701-7429
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Country | US
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Telephone | 612-501-0756
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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 | RPH-0017859
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 124528
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH6166
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License Number State | ND
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