Provider Demographics
NPI:1346863461
Name:NORTHSTAR TMS
Entity Type:Organization
Organization Name:NORTHSTAR TMS
Other - Org Name:NORTHSTAR PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:480-458-8320
Mailing Address - Street 1:65 SW YAMHILL ST STE 300
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97204-3316
Mailing Address - Country:US
Mailing Address - Phone:800-828-8417
Mailing Address - Fax:971-297-1360
Practice Address - Street 1:16100 NW CORNELL RD STE 220
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-7334
Practice Address - Country:US
Practice Address - Phone:800-828-8417
Practice Address - Fax:971-297-1360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-22
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty