NPI 1194209403 · live from the CMS NPI Registry
John Charles Eubanks
Registered Nurse, Psych/Mental Health, Adult in Portland, OR. National Provider Identifier 1194209403, active.
NPI record
| NPI | 1194209403 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Registered Nurse, Psych/Mental Health, Adult 163WP0809X |
| Practice location | 3710 Sw Us Veterans Hospital Rd, Portland, OR 97239 |
| Practice phone | 503-273-5049 |
| Mailing address | 3710 Sw Us Veterans Hospital Rd # 5c, Portland, OR 97239 |
| Enumerated | September 21, 2018 |
| Last updated | September 21, 2018 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse, Psych/Mental Health, Adult primary | 163WP0809X | 201806106RN (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.