Marilyn Sue Eubanks

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C3447 Issued in OR

Practice address

516 SE Morrison St
Suite 305
Portland, OR 97214-2327

Phone

(503) 236-3083

Fax

(971) 801-6014

NPI assigned

Jul 26, 2010

Last updated

Jun 13, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527

  WA

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1306192455
  NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD
• Rose City Therapists LLC

  • Professional Counselor
  • Portland, OR
  • NPI 1366036840
  NPD (past)

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402617600000",
    "number": "1508179029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 SE MORRISON ST",
            "address_2": "SUITE 305",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142327",
            "telephone_number": "503-236-3083",
            "fax_number": "971-801-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 SE MORRISON ST",
            "address_2": "SUITE 305",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142327",
            "telephone_number": "503-236-3083",
            "fax_number": "971-801-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUBANKS",
        "first_name": "MARILYN",
        "middle_name": "SUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-26",
        "last_updated": "2014-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C3447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Michael Ettinger, M.D.
• Emily Anne Etzkorn, MSW
• Amber Eubanks
• David Lee Eubanks, QMHA
• John Charles Eubanks
• Sean Robert Eubanks
• Thomas Richard Eubanks, D.O.
• Eudaemonia Equine Connections, Inc.
• Eudaemonia Equine Connections, Inc.
• Eugene Borkan, MD, PC

• Professional Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.