Ebisa Deressa

NPI #1003224064 in Portland, Oregon

Provider Information

NPI Number: 1003224064
Entity Type: Individual
Name: Ebisa Deressa
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: Jul 22, 2014
Last Updated: Jul 22, 2014

Practice Location

Address: 1123 N HAYDEN MEADOWS DR
City: Portland
State: Oregon
ZIP Code: 97217-7547
Phone: (503) 205-6661

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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