Individual
MR. DAVID EBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2303 E BURNSIDE ST, PORTLAND, OR 97214-1655
(503) 245-3370
Mailing address
6315 N CAMPBELL AVE, PORTLAND, OR 97217-4914
(503) 345-3370
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L003678
OR
Other
Enumeration date
02/04/2007
Last updated
07/08/2007
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