Healthcare Provider Details

I. General information

NPI: 1679659296
Provider Name (Legal Business Name): SEAN L STEWARD, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 PACIFIC AVE
FOREST GROVE OR
97116-2224
US

IV. Provider business mailing address

3838 PACIFIC AVE
FOREST GROVE OR
97116-2224
US

V. Phone/Fax

Practice location:
  • Phone: 503-992-0288
  • Fax: 503-359-4724
Mailing address:
  • Phone: 503-992-0288
  • Fax: 503-359-4724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. JUDY K VERBOORT
Title or Position: OFFICE ADMINISTRATOR
Credential:
Phone: 503-992-0288