Active NPI
Eric Wesley Ewing, LMT
- Community Health Worker
- Portland, OR
National Provider Identifier
1003111790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 16627
- Practice address
- 5845 NE Hoyt St Apt 204
Portland, OR 97213-3781 - Phone
- (707) 672-4123
- NPI assigned
- Jan 11, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 16627 | OR | Primary |
Addresses
Primary practice location
5845 NE Hoyt St Apt 204
Portland, OR 97213-3781
Mailing address
5845 NE Hoyt St Apt 204
Portland, OR 97213-3781
Phone (707) 672-4123
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16627 | OR | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294704000000",
"number": "1003111790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5845 NE HOYT ST APT 204",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972133781",
"telephone_number": "707-672-4123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5845 NE HOYT ST APT 204",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972133781",
"telephone_number": "707-672-4123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EWING",
"first_name": "ERIC",
"middle_name": "WESLEY",
"name_prefix": "Mr.",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-01-11",
"last_updated": "2011-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "OR",
"license": "16627",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.