Individual provider Active NPI

Tesfalem Zewdneh

  • Licensed Practical Nurse
  • Milwaukie, OR
National Provider Identifier
1972479731
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
201708692LPN Issued in OR
Practice address
11909 SE Stanley Ave
Milwaukie, OR 97222-2937
Phone
(971) 533-9390
Fax
(503) 855-3452
NPI assigned
Oct 16, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 201708692LPN OR Primary

Addresses

Primary practice location

11909 SE Stanley Ave
Milwaukie, OR 97222-2937

Mailing address

11881 SE Summer PL
Clackamas, OR 97015-5212
Phone (971) 533-9390

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
201708692LPNORMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Rainmere Treatment Home LLC PastSince Oct 21, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1760572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1972479731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11881 SE SUMMER PL",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155212",
            "telephone_number": "971-533-9390",
            "fax_number": "503-855-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11909 SE STANLEY AVE",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972222937",
            "telephone_number": "971-533-9390",
            "fax_number": "503-855-3452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEWDNEH",
        "first_name": "TESFALEM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-16",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OR",
            "license": "201708692LPN",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 16, 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.