Individual provider Active NPI

Gelgelu Yadeto

  • Mental Illness Community Based Residential Treatment Facility
  • Portland, OR
National Provider Identifier
1710895594
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Practice address
3632 SE 151St Ave
Portland, OR 97236-2230
Phone
(503) 516-0632
NPI assigned
Aug 31, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X OR Primary

Addresses

Primary practice location

3632 SE 151St Ave
Portland, OR 97236-2230

Mailing address

3632 SE 151St Ave
Portland, OR 97236-2230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1710895594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3632 SE 151ST AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972362230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3632 SE 151ST AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972362230",
            "telephone_number": "503-516-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YADETO",
        "first_name": "GELGELU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.