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TESFAYE GOMALO
NPI 1255299749
Community Based Residential Treatment Facility, Mental Illness in Salem, OR

Active since January 13, 2026
4436 JADE ST NE, SALEM, OR 97305(971) 258-6432 Get Directions Write a Review

NPPES record last updated: January 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Tesfaye Gomalo NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TESFAYE GOMALO (NPI 1255299749) is an individual community based residential treatment facility, mental illness provider in Salem, Oregon, licensed in Oregon (RTH100295) and active in the NPI registry since January 2026.

NPPES Registry Identity

NPI1255299749
Entity TypeIndividualMale
Primary Taxonomy320800000X
Provider Legal NameTESFAYE GOMALO
Location Address4436 JADE ST NESalem, OR 97305-2233
Mailing Address4436 Jade St NeSalem, OR 97305-2233 · (971) 258-6432
Phone(971) 258-6432
Sole ProprietorYes
Enumeration DateJanuary 13, 2026
NPPES CertifiedJanuary 13, 2026
✔ NPI 1255299749 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Mental IllnessResidential Treatment Facilities
Taxonomy Code320800000X
License✔ Licensed in OR · RTH100295
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
4436 JADE ST NE, Salem, OR 97305
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FAMILY RESIDENTIAL TREATMENT HOME
Community Based Residential Treatment Facility, Mental Illness
4436 JADE ST NE
SALEM, OR 97305
Marion County (971) 258-6432

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tesfaye Gomalo's NPI number?

The NPI number for Tesfaye Gomalo is 1255299749. It was assigned to this individual provider in the NPPES registry on January 13, 2026.

Where is Tesfaye Gomalo located?

Tesfaye Gomalo practices at 4436 Jade St NE, Salem, OR 97305. The listed phone number is (971) 258-6432.

What is Tesfaye Gomalo's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.

When was this NPI record last updated?

The NPPES record for Tesfaye Gomalo was last updated on January 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.