Individual provider Active NPI

Sami Lee Ebner, DC, ND

  • Naturopath
  • Portland, OR
National Provider Identifier
1619627759
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
5133 Issued in OR
Practice address
436 SE 12TH Ave
Portland, OR 97214-1323
Phone
(971) 359-0012
Fax
(971) 484-1992
NPI assigned
Mar 23, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X 5133 OR Primary
Chiropractor 111N00000X 6224 OR

Addresses

Primary practice location

436 SE 12TH Ave
Portland, OR 97214-1323

Mailing address

436 SE 12TH Ave
Portland, OR 97214-1323
Phone (971) 359-0012

Other practice location 1

1330 SE Cesar E Chavez Blvd
Portland, OR 97214-4322
Phone (503) 232-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220801000296 OR Practitioner - Chiropractic 5395127807 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6224ORMDPhysical Therapist
5133ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Natural Medicine, Inc Chiropractor CurrentSince Mar 3, 2024 Accepting new patients
Be Well Acupuncture Chiropractor CurrentSince Jun 1, 2022 Accepting new patients
Be Well Acupuncture Past Accepting new patients
Be Well Acupuncture Past Accepting new patients
Be Well Acupuncture Past Accepting new patients
Be Well Acupuncture Past Accepting new patients
Be Well Acupuncture Naturopath Past Accepting new patients
Be Well Acupuncture Chiropractor Past Accepting new patients
Be Well Acupuncture Chiropractor Past Accepting new patients
Be Well Acupuncture Past Accepting new patients
Be Well Acupuncture Chiropractor Past Accepting new patients
Be Well Acupuncture Past Accepting new patients

Locations

1330 SE Cesar E Chavez Blvd
Portland, OR 97214
Phone (503) 232-1100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22798/brand/1/csg/1/fhir/r4
  • Direct secure messaging: sami.ebner.1@22798.direct.athenahealth.com

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1619627759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 SE 12TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141323",
            "telephone_number": "971-359-0012",
            "fax_number": "971-484-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 SE 12TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141323",
            "telephone_number": "971-359-0012",
            "fax_number": "971-484-1992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1330 SE Cesar E Chavez Blvd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972144322",
            "country_code": "US",
            "telephone_number": "503-232-1100",
            "fax_number": "503-232-7751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EBNER",
        "first_name": "SAMI",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DC, ND",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-23",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "5133",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "6224",
            "primary": false
        }
    ],
    "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 Aug 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.