| Seth S Williams Psyd Llc | |
|
14511 Westlake Dr Suite 120 Lake Oswego OR 97035-7783 | |
| (503) 752-0122 | |
| (508) 433-1871 |
| Full Name | Seth S Williams Psyd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 14511 Westlake Dr, Lake Oswego, Oregon |
| Authorized Official Name and Position | Seth Saturn Williams (OWNER) |
| Authorized Official Contact | 5037520122 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Seth S Williams Psyd Llc 6107 Sw Murray Blvd Beaverton OR 97008-4421 Ph: (503) 752-0122 | Seth S Williams Psyd Llc 14511 Westlake Dr Suite 120 Lake Oswego OR 97035-7783 Ph: (503) 752-0122 |
| NPI Number | 1548710148 |
|---|---|
| Provider Enumeration Date | 10/06/2016 |
| Last Update Date | 10/06/2016 |
| Medicare PECOS PAC ID | 8022397868 |
|---|---|
| Medicare Enrollment ID | O20161117002267 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548710148 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2227 (Oregon) | Primary |
| Provider Name | Seth S Williams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851331599 PECOS PAC ID: 6002810066 Enrollment ID: I20130809000004 |
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