Paul Ebensteiner, DC
Individual provider Active NPI Chiropractor · Portland, OR
NPI 1669875282 · NPPES record last updated Apr 3, 2024
Key facts
- NPI
- 1669875282
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 5583 (OR)
- Practice address
- 5424 SE 82ND Ave
Portland, OR 97266-4811 - Phone
- (503) 477-8720
- Fax
- (503) 746-5328
- NPI assigned
- Sep 28, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5583 | OR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oregon Trail Integrative Care, LLC | Past |
Accepting new patients | |
| Oregon Trail Chiropractic LLC | Chiropractor | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5583 | OR | Yes |
Addresses
Primary practice location
5424 SE 82ND Ave
Portland, OR 97266-4811
Mailing address
5424 SE 82ND Ave
Portland, OR 97266-4811
Phone (503) 477-8720
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.