EBERHEARDT BANE ELFVING PWS, QMHA-R - NPI 1255031860

Q: What is the provider's specialty?

The provider's specialty is Peer Specialist with taxonomy code 175T00000X.

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About Eberheardt Bane Elfving Pws, Qmha-r NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EBERHEARDT BANE ELFVING PWS, QMHA-R (NPI 1255031860) is an individual peer specialist in Portland, Oregon, licensed in Oregon (THW000108617) and active in the NPI registry since March 2023.

NPPES Registry Identity

NPI1255031860

Entity TypeIndividualMale

Primary Taxonomy175T00000X

Provider Legal NameEBERHEARDT BANE ELFVINGCredential: PWS, QMHA-R

Location Address5329 NE MARTIN LUTHER KING JR BLVDPortland, OR 97211-3237

Mailing Address619 Nw 6th Ave Fl 7Portland, OR 97209-3991

Phone(503) 988-5558

Sole ProprietorNo

Enumeration DateMarch 3, 2023

Last NPPES UpdateOctober 16, 20252 updates tracked since enumeration

NPPES CertifiedOctober 16, 2025

✔ NPI 1255031860 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPeer SpecialistOther Service Providers

Taxonomy Code175T00000X

License✔ Licensed in OR · THW000108617

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X · License 25-QMHA-R-7213 (OR)

5329 NE MARTIN LUTHER KING JR BLVD, Portland, OR 97211

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