Williams, Vern R
Williams, Vern R is an individual health care provider with primary practice located at 15 N Morris St , Portland OR 97227-1541. He recently has only one registered license in Allopathic & Osteopathic Physicians / Addiction Medicine, which is considered as his primary health care specialty. Williams, Vern R can be contacted via phone (503) 230-9875.Contact Information
Primary practice address
15 N Morris St
Portland OR 97227-1541
Phone: (503) 230-9875
Fax: (503) 230-9877
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207RA0401X | MD14502 | Oregon |
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207RA0401X | MD-17867 | Hawaii |
Profile Details
| NPI number | 1619967577 |
|---|---|
| LBN Legal business name | Williams, Vern R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 24th, 2005 |
| Last updated | Apr 14th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619967577 | NPPES |
| Washington | MEDICAID | 2107839 | |
| Washington | MEDICAID | 134254 |
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