Individual
DR. STEPHEN JOSEPH EBNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10100 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 786-8435
Mailing address
4207 SE HULL AVE, MILWAUKIE, OR 97267-6444
(503) 652-6902
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
MD00034626
WA
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
OR MD13345
OR
Other
Enumeration date
08/24/2006
Last updated
07/08/2007
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