Provider Demographics
NPI:1679579270
Name:SEBERS, STEVEN L (FACO)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:L
Last Name:SEBERS
Suffix:
Gender:M
Credentials:FACO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 SE SUNNYSIDE RD
Mailing Address - Street 2:STE 214N
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-5703
Mailing Address - Country:US
Mailing Address - Phone:503-653-9697
Mailing Address - Fax:503-653-9691
Practice Address - Street 1:8800 SE SUNNYSIDE RD
Practice Address - Street 2:STE 214N
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-5703
Practice Address - Country:US
Practice Address - Phone:503-653-9697
Practice Address - Fax:503-653-9691
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27-2564111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR009659Medicaid
ORT92728Medicare UPIN
ORR107362Medicare ID - Type Unspecified