Active NPI
Arsie Wodesso
- Other Technician
- Milwaukie, OR
National Provider Identifier
1083578728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- Practice address
- 6188 SE Oetkin Rd
Milwaukie, OR 97267-3207 - Phone
- (503) 997-3070
- NPI assigned
- Dec 15, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | OR | Primary |
Addresses
Primary practice location
6188 SE Oetkin Rd
Milwaukie, OR 97267-3207
Mailing address
6188 SE Oetkin Rd
Milwaukie, OR 97267-3207
Phone (503) 997-3070
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39-4141410 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1765756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765756800000",
"number": "1083578728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6188 SE OETKIN RD",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "972673207",
"telephone_number": "503-997-3070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6188 SE OETKIN RD",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "972673207",
"telephone_number": "503-997-3070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WODESSO",
"first_name": "ARSIE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-12-15",
"last_updated": "2025-12-15",
"certification_date": "2025-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "OR",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39-4141410",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milwaukie, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.