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General NPI Number Information
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NPI Number | 1962851212
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Entity Type | Individual
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Provider Name | MIHRETU DESSALEGNE
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Gender | Male
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Dates
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Enumeration Date | 06/07/2016
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Last Update Date | 12/28/2025
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Provider Practice Location Address
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Address Line | 8800 SE SUNNYSIDE RD STE 122S
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City | CLACKAMAS
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State | OR
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Zip | 97015-5702
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Country | US
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Telephone | 971-808-2686
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Fax | 503-214-8732
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Provider Business Mailing Address
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Address Line | 7320 SW HUNZIKER RD STE 204
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City | TIGARD
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State | OR
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Zip | 97223-2301
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Country | US
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Telephone | 971-808-2686
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Fax | 503-214-8732
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C8387
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License Number State | OR
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