MR. BERHANU KEBEDE BEDASSA PMHNP NPI 1093260622

NPI Information

NPI: 1093260622
Provider Name: MR. BERHANU KEBEDE BEDASSA, PMHNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
13250 NE SHAVER ST
PORTLAND, OR
ZIP 97230
Phone: (213) 249-6973
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MR. Berhanu Kebede Bedassa, PMHNP is a psychiatric/mental health nurse practitioner in Portland, OR with 8 years of experience. MR. Berhanu Kebede Bedassa, PMHNP NPI is 1093260622. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

13250 NE SHAVER ST
PORTLAND, OR
ZIP 97230-453
Phone: (213) 249-6973

The NPI 1093260622 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/24/2016 and was last updated on 11/1/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		RN61256180	WASHINGTON	No
2	363LF0000X	Nurse Practitioner	Family	95004776	CALIFORNIA	No
3	163W00000X	Registered Nurse		201606248RN	OREGON	No
4	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	AP61370238	WASHINGTON	No
5	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	201707152NP-PP	OREGON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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