Individual provider · Type 1 NPI
Addis Mekuria
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Happy Valley, OR
Practice location
9477 SE Maloney Pl
Happy Valley, OR 97086-3719
Mailing address
17708 SE Paradise Dr
Portland, OR 97267-5846
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | None listed |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
About NPI 1730099540
Addis Mekuria's National Provider Identifier is 1730099540, issued on Sep 11, 2026. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Happy Valley, OR. The record was last updated on Sep 11, 2026.