Provider Demographics
NPI:1881714061
Name:2 ROADS CROSSING HEALTHCARE, PC
Entity type:Organization
Organization Name:2 ROADS CROSSING HEALTHCARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:SAEKS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LAC
Authorized Official - Phone:503-617-0450
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:97006-8116
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:97006-8116
Practice Address - Country:US
Practice Address - Phone:503-617-0450
Practice Address - Fax:503-617-0475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1425103TC0700X
ORAC00792171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty