Individual
MR. FORREST GUY SIPPEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, CDP, CADCII
Contact information
Practice address
9700 SW BEAVERTON HILLSDALE HWY, BEAVERTON, OR 97005-3306
(503) 626-9494
(503) 646-5671
Mailing address
PO BOX 82819, PORTLAND, OR 97282-0819
(503) 626-9494
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
09- R-15
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP00006216
WA
101YM0800X
Mental Health Counselor
19-QMHPC-00775
OR
Other
Enumeration date
02/12/2007
Last updated
02/12/2020
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