Provider Demographics
NPI:1255007167
Name:EBY, HELEN ANN
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:ANN
Last Name:EBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5153 WESLEY AVE SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-3933
Mailing Address - Country:US
Mailing Address - Phone:503-929-8476
Mailing Address - Fax:
Practice Address - Street 1:5153 WESLEY AVE SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-3933
Practice Address - Country:US
Practice Address - Phone:503-929-8476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA10917171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter