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DAVID LEE EUBANKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
QMHA

Contact information

Practice address
412 SW 12TH AVE, PORTLAND, OR 97205-2329
(503) 552-5113
(503) 273-8431
Mailing address
11014 NE WYGANT ST, PORTLAND, OR 97220-2563
(503) 552-5113

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
01/22/2007
Last updated
10/09/2007
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