Provider Demographics
NPI:1437422573
Name:DR STEPHEN BESSER DC INC
Entity Type:Organization
Organization Name:DR STEPHEN BESSER DC INC
Other - Org Name:BACK PAIN RELIEF CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BESSER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-746-5085
Mailing Address - Street 1:13305 NW CORNELL RD
Mailing Address - Street 2:STE E
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-5987
Mailing Address - Country:US
Mailing Address - Phone:503-746-5085
Mailing Address - Fax:503-972-1185
Practice Address - Street 1:13305 NW CORNELL RD
Practice Address - Street 2:STE E
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-5987
Practice Address - Country:US
Practice Address - Phone:503-746-5085
Practice Address - Fax:503-972-1185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-21
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4114111N00000X
OR21904225700000X
OR21298225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty