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NPI Code Detail

MEDICARE: SEAN L STEWARD, MD, PC

MEDICARE: SEAN L STEWARD, MD, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QU0200XUrgent Care Clinic/Center12202-001OR
2261QP2300XPrimary Care Clinic/Center260204-95OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154662849
Entity Type Code : Organization
Provider Name (Legal Business Name) : SEAN L STEWARD, MD, PC
Provider Business Mailing Address
First Line : 3838 PACIFIC AVE
Second Line :
City : FOREST GROVE
State : OR
Zip : 97116-2224
Country : US
Telephone Number : 503-992-0288
Fax Number : 503-359-4724
Provider Business Practice Location Address
First Line : 3838 PACIFIC AVE
Second Line :
City : FOREST GROVE
State : OR
Zip : 97116-2224
Country : US
Telephone Number : 503-992-0288
Fax Number : 503-359-4724
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. THERESE MARIE GORMAN-STEWARD
Credential : MA
Telephone Number : 503-992-0288
Provider Enumeration Date : 03/06/2013
Last Update Date : 03/06/2013

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