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Individual

CHAYSE EBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2405 NE DIAMOND LAKE BLVD STE 75, ROSEBURG, OR 97470-5924
(541) 900-1418
(541) 900-1419
Mailing address
2405 NE DIAMOND LAKE BLVD STE 75, ROSEBURG, OR 97470-5924
(541) 900-1418
(541) 900-1419

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-209945
AK
225100000X
Physical Therapist
Primary
66230
OR

Other

Enumeration date
04/05/2022
Last updated
08/13/2026
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