Provider Demographics
NPI:1992485577
Name:ASHAGRE, NEBIYU
Entity type:Individual
Prefix:
First Name:NEBIYU
Middle Name:
Last Name:ASHAGRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 KELLOGG BLVD E APT 3007
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-1228
Mailing Address - Country:US
Mailing Address - Phone:651-274-7262
Mailing Address - Fax:
Practice Address - Street 1:111 KELLOGG BLVD E APT 3007
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-1228
Practice Address - Country:US
Practice Address - Phone:651-274-7262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist