Provider Demographics
NPI:1801145479
Name:EBEL, AMY LYNN (PHARMD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:EBEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:OBERSINNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:635 N ARROWLEAF TRL
Mailing Address - Street 2:
Mailing Address - City:SISTERS
Mailing Address - State:OR
Mailing Address - Zip Code:97759-3235
Mailing Address - Country:US
Mailing Address - Phone:541-549-6221
Mailing Address - Fax:541-549-1110
Practice Address - Street 1:635 N ARROWLEAF TRL
Practice Address - Street 2:
Practice Address - City:SISTERS
Practice Address - State:OR
Practice Address - Zip Code:97759
Practice Address - Country:US
Practice Address - Phone:541-549-6221
Practice Address - Fax:541-549-1110
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0013189183500000X
OR00131891835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist