Provider Demographics
NPI:1851331599
Name:WILLIAMS, SETH SATURN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:SATURN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:SETH
Other - Middle Name:
Other - Last Name:SATURN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3158
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3158
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12442 SW SCHOLLS FERRY RD
Practice Address - Street 2:SUITE 106
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-0803
Practice Address - Country:US
Practice Address - Phone:503-216-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4633103TC0700X
OR2227103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN311P4WIOtherBCBS NUMBER
MN729458100Medicaid
MNHP58055OtherHP NUMBER