Active NPI
Stephen Douglas Saeks, PHD, LAC
- Clinical Psychologist
- Beaverton, OR
National Provider Identifier
1952486847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1425
- Practice address
- 15455 NW Greenbrier Pkwy
Suite 240
Beaverton, OR 97006-7374 - Phone
- (503) 617-0450
- Fax
- (503) 617-0475
- NPI assigned
- Oct 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1425 | OR | Primary |
| Acupuncturist | 171100000X | AC00792 | OR |
Addresses
Primary practice location
15455 NW Greenbrier Pkwy
Suite 240
Beaverton, OR 97006-7374
Mailing address
15455 NW Greenbrier Pkwy
Suite 240
Beaverton, OR 97006-7374
Phone (503) 617-0450
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PS424OR | Medicaid | OR | |
| 8445124 | Medicaid | WA | |
| 023141 | Medicaid | OR | |
| 807417100 | Medicaid | ID | |
| 93125743797239A626 | Other | OR | TRIWEST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC00792 | OR | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 2 Roads Crossing Healthcare, PC | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312243200000",
"number": "1952486847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15455 NW GREENBRIER PKWY",
"address_2": "SUITE 240",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970067374",
"telephone_number": "503-617-0450",
"fax_number": "503-617-0475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15455 NW GREENBRIER PKWY",
"address_2": "SUITE 240",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970067374",
"telephone_number": "503-617-0450",
"fax_number": "503-617-0475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAEKS",
"first_name": "STEPHEN",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "PHD, LAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2011-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "1425",
"primary": true
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "OR",
"license": "AC00792",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PS424OR",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8445124",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "023141",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "807417100",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIWEST",
"identifier": "93125743797239A626",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.