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Mignot Ketema Shibru

Adult Companion in Oregon City, OR. Individual provider (NPI-1).

NPI number1619873635
StatusActive
Last updated in NPPESOct 16, 2026

Details

NPI
1619873635
Entity type
Individual (NPI-1)
Name
Mignot Ketema Shibru
Sex
Male
Sole proprietor
Yes
Enumeration date
Oct 16, 2026
Certification date
Oct 16, 2026
Last updated
Oct 16, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
372600000X Adult Companion––Yes

Practice location

18814 S End Rd
Oregon City, OR 97045-7786

Phone 503-381-1960 · Fax 503-381-1960

Mailing address

18814 S End Rd
Oregon City, OR 97045-7786

Phone 503-381-1960 · Fax 503-381-1960

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