Mulusew Getie Kebtie, RN, BSN, MSC

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

201808581RN Issued in OR

Practice address

16730 Buckingham Dr
Gladstone, OR 97027-1044

Phone

(301) 633-9649

Fax

(503) 344-6669

NPI assigned

Nov 8, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Light Residential Service LLC

  • Registered Nurse
  • Gladstone, OR
  • NPI 1043929664
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1073221289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16730 BUCKINGHAM DR",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970271044",
            "telephone_number": "301-633-9649",
            "fax_number": "503-344-6669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16730 BUCKINGHAM DR",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970271044",
            "telephone_number": "301-633-9649",
            "fax_number": "503-344-6669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEBTIE",
        "first_name": "MULUSEW",
        "middle_name": "GETIE",
        "credential": "RN, BSN, MSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201808581RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miriam R Jones, LMT
• Taylor Jade Jones, LPC
• Tomanique Jones
• Margaret 'Page' Kalkowski
• Jeremy S Kato, DDS
• Patricia A Keeler
• Emily Keith
• Jerry Keith, LPC
• Rachel Kelly, ND
• Rachel Kenner

• Registered Nurse in Gladstone, OR
• Providers in Gladstone, OR by specialty
• Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.