Provider Demographics
NPI:1407723133
Name:HELSABO, TEMESGEN
Entity type:Individual
Prefix:
First Name:TEMESGEN
Middle Name:
Last Name:HELSABO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15710 SE WEBSTER RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97267-4233
Mailing Address - Country:US
Mailing Address - Phone:971-401-2829
Mailing Address - Fax:
Practice Address - Street 1:6830 SE MOLT ST
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97267-3228
Practice Address - Country:US
Practice Address - Phone:971-401-2829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-18
Last Update Date:2025-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10015365163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty