Individual provider Active NPI

Luwan Tesafsilase

  • Driver
  • Happy Valley, OR
National Provider Identifier
1124816228
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
881489249 Issued in OR
Practice address
11150 SE Causey Cir
Happy Valley, OR 97086-4709
Phone
(206) 530-9229
NPI assigned
Apr 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X 881489249 OR Primary

Addresses

Primary practice location

11150 SE Causey Cir
Happy Valley, OR 97086-4709

Mailing address

11150 SE Causey Cir
Happy Valley, OR 97086-4709
Phone (206) 530-9229

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

LicenseStateTypeSpecialty
881489249ORMDDriver

NPI Registry JSON

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

{
    "created_epoch": "1745798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1124816228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11150 SE CAUSEY CIR",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970864709",
            "telephone_number": "206-530-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11150 SE CAUSEY CIR",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970864709",
            "telephone_number": "206-530-9229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESAFSILASE",
        "first_name": "LUWAN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "OR",
            "license": "881489249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Happy Valley, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.

Verify at the official NPI Registry.