Provider Demographics
NPI:1164699021
Name:BEYOND ADDICTIONS
Entity Type:Organization
Organization Name:BEYOND ADDICTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SEPPALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-644-8700
Mailing Address - Street 1:8285 SW NIMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-6447
Mailing Address - Country:US
Mailing Address - Phone:503-644-8700
Mailing Address - Fax:503-641-5179
Practice Address - Street 1:8285 SW NIMBUS AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-6447
Practice Address - Country:US
Practice Address - Phone:503-644-8700
Practice Address - Fax:503-641-5179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR22576261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder