NPIMap

Individual provider Active NPI

Mollie Ebner, DO

  • Family Medicine Physician
  • Portland, OR
National Provider Identifier
1730543034
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO204259 Issued in OR
Practice address
6445 N Greeley Ave
Portland, OR 97217-5023
Phone
(503) 285-6607
Fax
(503) 285-3195
NPI assigned
Apr 12, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO204259 OR Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

6445 N Greeley Ave
Portland, OR 97217-5023

Mailing address

PO Box 1517
Pendleton, OR 97801-0410
Phone (877) 708-1119

Other practice location 1

3033 NE Davis St
Portland, OR 97232-3238
Phone (503) 957-6569

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210702002049 OR Practitioner - Family Practice 5193146041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Praxis Health PCGroup PAC ID 8325941446, 174 clinicians

Practice addresses (Care Compare)

6445 N Greeley Ave
Portland, OR 97217-5023
Phone (503) 283-6607

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Praxis Health, PC Multi-Specialty CurrentSince Aug 1, 2021 Accepting new patients
Praxis Health, PC CurrentSince Aug 1, 2021 Accepting new patients

Locations

4510 SW Hall Blvd
Beaverton, OR 97005
Phone (503) 644-1171

6445 N Greeley Ave
Portland, OR 97217
Phone (503) 283-6607

Interoperability endpoints

  • Direct secure messaging: miebner@pacificmedicalgroup.directbygreenway.com

Organizations & group practices 2

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1730543034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1517",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978010410",
            "telephone_number": "877-708-1119",
            "fax_number": "541-278-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6445 N GREELEY AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972175023",
            "telephone_number": "503-285-6607",
            "fax_number": "503-285-3195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3033 NE Davis St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972323238",
            "country_code": "US",
            "telephone_number": "503-957-6569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EBNER",
        "first_name": "MOLLIE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-12",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO204259",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.