John Charles Eubanks

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

201806106RN Issued in OR

Practice address

3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964

Phone

(503) 273-5049

NPI assigned

Sep 21, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1194209403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3710 SW US VETERANS HOSPITAL RD # 5C",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 SW US VETERANS HOSPITAL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392964",
            "telephone_number": "503-273-5049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUBANKS",
        "first_name": "JOHN",
        "middle_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-21",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "OR",
            "license": "201806106RN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON NURSING LICENSE",
            "identifier": "201806106RN",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandie Ettinger, O.T.
• Kenneth Michael Ettinger, M.D.
• Emily Anne Etzkorn, MSW
• Amber Eubanks
• David Lee Eubanks, QMHA
• Marilyn Sue Eubanks
• Sean Robert Eubanks
• Thomas Richard Eubanks, D.O.
• Eudaemonia Equine Connections, Inc.
• Eudaemonia Equine Connections, Inc.

• Adult Psychiatric/Mental Health Registered Nurse in Portland, OR
• Providers in Portland, OR by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.