Provider Demographics
NPI:1891230082
Name:BEGGS, ERIC SEAN (LMT, VCSW)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:SEAN
Last Name:BEGGS
Suffix:
Gender:M
Credentials:LMT, VCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17933 NW EVERGREEN PKWY
Mailing Address - Street 2:SUITE 285
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-7659
Mailing Address - Country:US
Mailing Address - Phone:503-828-9265
Mailing Address - Fax:
Practice Address - Street 1:17933 NW EVERGREEN PKWY
Practice Address - Street 2:SUITE 285
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-7659
Practice Address - Country:US
Practice Address - Phone:503-828-9265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-27
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5891225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist