Provider Demographics
NPI:1144361924
Name:SIPPEY, FORREST GUY (MSW, CDP, CADCII)
Entity type:Individual
Prefix:MR
First Name:FORREST
Middle Name:GUY
Last Name:SIPPEY
Suffix:
Gender:M
Credentials:MSW, CDP, CADCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 82819
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97282-0819
Mailing Address - Country:US
Mailing Address - Phone:503-626-9494
Mailing Address - Fax:
Practice Address - Street 1:9700 SW BEAVERTON HILLSDALE HWY
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3306
Practice Address - Country:US
Practice Address - Phone:503-626-9494
Practice Address - Fax:503-646-5671
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19-QMHPC-00775101YM0800X
OR09- R-15101YA0400X
WACP00006216101YA0400X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health