Eberheardt Bane Elfving, PWS, QMHA-R

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

THW000108617 Issued in OR

Practice address

5329 NE Martin Luther King Jr Blvd
Portland, OR 97211-3237

Phone

(503) 988-5558

NPI assigned

Mar 3, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cascadia Health

  • Multi-Specialty Clinic/Center
  • Portland, OR
  • NPI 1447337753
  NPD (past)

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

{
    "created_epoch": "1677801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1255031860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 NW 6TH AVE FL 7",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5329 NE MARTIN LUTHER KING JR BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972113237",
            "telephone_number": "503-988-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELFVING",
        "first_name": "EBERHEARDT",
        "middle_name": "BANE",
        "credential": "PWS, QMHA-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-03",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW000108617",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OR",
            "license": "25-QMHA-R-7213",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elevatedbodyworks LLC
• Elevatemind Wellness LLC
• Eleven Eleven, LLC
• Mark William Elfering, B.S.
• Jessica Elfin
• Whitney Elg-Salsman, D.O.
• Danica Leigh Elgin, PT, DPT
• Mary Elhachem
• Salim Elhalaby, NP
• Ajit Yi Elhance

• Peer Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; 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.