Provider Demographics
NPI:1225925738
Name:MEKURIYA, BEWUQETU ABEBE (RN)
Entity type:Individual
Prefix:
First Name:BEWUQETU
Middle Name:ABEBE
Last Name:MEKURIYA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6108 SE CLATSOP ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-0708
Mailing Address - Country:US
Mailing Address - Phone:202-352-4712
Mailing Address - Fax:
Practice Address - Street 1:6108 SE CLATSOP ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-0708
Practice Address - Country:US
Practice Address - Phone:202-352-4712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health