Individual
MR. MICAH DOMINIC ECKBURG I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSS
Contact information
Practice address
715 LINCOLN ST, EUGENE, OR 97401-2502
(541) 344-3574
(541) 344-5652
Mailing address
82272 RIVER DR, CRESWELL, OR 97426-9861
(541) 206-7673
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
111140
OR
175T00000X
Peer Specialist
Primary
111140
OR
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/29/2024
Last updated
02/18/2026
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