Provider Demographics
NPI:1467174771
Name:EBLING, BRANDON WILLIAM
Entity Type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:WILLIAM
Last Name:EBLING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 CUBIT ST APT 216
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-8748
Mailing Address - Country:US
Mailing Address - Phone:541-632-2950
Mailing Address - Fax:
Practice Address - Street 1:2350 CUBIT ST APT 115
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-8747
Practice Address - Country:US
Practice Address - Phone:541-632-2950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care