Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 27-2564 | OR |
NPI | 1679579270 |
---|---|
Provider Name | Dr. Steven L Sebers |
First Address | Clackamas, OR 97015-5703 |
Second Address | Clackamas, OR 97015-5703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009659 | (05) | OR |
T92728 | (02) | OR |