Active NPI
Gediyon Etafe
- Driver
- Columbia City, OR
National Provider Identifier
1952279812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- 6167878
- Practice address
- 1725 1St St
Columbia City, OR 97018-9501 - Phone
- (510) 925-9014
- NPI assigned
- Oct 23, 2025
- 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 | 6167878 | OR | Primary |
Addresses
Primary practice location
1725 1St St
Columbia City, OR 97018-9501
Mailing address
1725 1St St
Columbia City, OR 97018-9501
Phone (510) 925-9014
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 |
|---|---|---|---|
| 6167878 | OR | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1761177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761177600000",
"number": "1952279812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1725 1ST ST",
"city": "COLUMBIA CITY",
"state": "OR",
"postal_code": "970189501",
"telephone_number": "510-925-9014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1725 1ST ST",
"city": "COLUMBIA CITY",
"state": "OR",
"postal_code": "970189501",
"telephone_number": "510-925-9014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETAFE",
"first_name": "GEDIYON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-10-23",
"last_updated": "2025-10-23",
"certification_date": "2025-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Driver",
"state": "OR",
"license": "6167878",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia City, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.