Individual
JOHN CHARLES EUBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(503) 273-5049
Mailing address
3710 SW US VETERANS HOSPITAL RD # 5C, PORTLAND, OR 97239-2964
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
201806106RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201806106RN
OREGON NURSING LICENSE
OR
Enumeration date
09/21/2018
Last updated
09/21/2018
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