Provider Demographics
NPI:1952486847
Name:SAEKS, STEPHEN DOUGLAS (PHD, LAC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:DOUGLAS
Last Name:SAEKS
Suffix:
Gender:M
Credentials:PHD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15455 NW GREENBRIER PKWY
Mailing Address - Street 2:SUITE 240
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-7374
Mailing Address - Country:US
Mailing Address - Phone:503-617-0450
Mailing Address - Fax:503-617-0475
Practice Address - Street 1:15455 NW GREENBRIER PKWY
Practice Address - Street 2:SUITE 240
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-7374
Practice Address - Country:US
Practice Address - Phone:503-617-0450
Practice Address - Fax:503-617-0475
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1425103TC0700X
ORAC00792171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORPS424ORMedicaid
WA8445124Medicaid
OR023141Medicaid
ID807417100Medicaid
OR93125743797239A626OtherTRIWEST
OR93125743797239A626OtherTRIWEST
ID807417100Medicaid