Active NPI
Meseret Mehretab Asfeha
- Driver
- Portland, OR
National Provider Identifier
1093396558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- 4368954
- Practice address
- 3327 SE 127TH PL
Portland, OR 97236-3218 - Phone
- (503) 502-5048
- NPI assigned
- Apr 16, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Driver | 172A00000X | 4368954 | OR | Primary |
Addresses
Primary practice location
3327 SE 127TH PL
Portland, OR 97236-3218
Mailing address
3327 SE 127TH PL
Portland, OR 97236-3218
Phone (503) 502-5048
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47-1107956 | 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4368954 | OR | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618531200000",
"number": "1093396558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3327 SE 127TH PL",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972363218",
"telephone_number": "503-502-5048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3327 SE 127TH PL",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972363218",
"telephone_number": "503-502-5048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ASFEHA",
"first_name": "MESERET",
"middle_name": "MEHRETAB",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-04-16",
"last_updated": "2021-04-16",
"certification_date": "2021-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "OR",
"license": "4368954",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47-1107956",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.