Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Eyerusalem Woldu

Individual provider Mental Illness Community Based Residential Treatment Facility · NPI 1912887621

Eyerusalem Woldu is a Mental Illness Community Based Residential Treatment Facility in Happy Valley, Oregon. Practices as a sole proprietor. Licensed in Oregon.

Licensed in
OR
In the registry since
2025

Practice location Address checks out

12684 SE Majestic Ln
Happy Valley, OR 97086-9313
Phone: (769) 447-7780
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Illness Community Based Residential Treatment Facility (primary) Taxonomy 320800000X (OR)

Record details

NPI number1912887621
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 3, 2025
Last updated in NPPESSeptember 3, 2025
Certification dateAugust 30, 2025
Mailing address445 E Berkeley St, Gladstone, OR 97027-2419

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