NPI 1346707296

Dastu I Ahmat

Practitioner Adult Care Home Facility Gresham, OR

Practice location

Address: 55 NW 23rd St, Gresham, OR 97030-2640
Phone: (503) 984-6216

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X Licence 11146 (OR)

Other Custodial Care Facility providers in Oregon →

Registry record

NPI: 1346707296
Entity type: Individual
Sex (as registered): Female
NPI issued: 27 Feb 2019
Record last updated: 27 Feb 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.