Provider Demographics
NPI:1699209791
Name:WILLIAMS, MICHELLE MARIE (ND)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 SE MORRISON ST STE 160
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-6309
Mailing Address - Country:US
Mailing Address - Phone:503-882-0752
Mailing Address - Fax:503-908-6742
Practice Address - Street 1:819 SE MORRISON ST STE 160
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-6309
Practice Address - Country:US
Practice Address - Phone:503-882-0752
Practice Address - Fax:503-908-6742
Is Sole Proprietor?:No
Enumeration Date:2017-04-14
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60814756175F00000X
OR4074175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath