Basic Information
| Provider Information | |||||||||
| NPI: | 1093278871 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EBY | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | PALUMBO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 965 TUCKER RD | ||||||||
| Address2: | |||||||||
| City: | HOOD RIVER | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970319591 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5413866665 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 965 TUCKER RD | ||||||||
| Address2: | |||||||||
| City: | HOOD RIVER | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970319591 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5413866665 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2019 | ||||||||
| LastUpdateDate: | 08/08/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 172V00000X | OR | N | Other Service Providers | Community Health Worker | 101YA0400X | T-20-090 | OR | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.