Provider Demographics
NPI:1205663739
Name:WATSON, RAHEEM JAHMEL (PWS)
Entity type:Individual
Prefix:
First Name:RAHEEM
Middle Name:JAHMEL
Last Name:WATSON
Suffix:
Gender:M
Credentials:PWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 SE 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-2224
Mailing Address - Country:US
Mailing Address - Phone:480-881-4555
Mailing Address - Fax:
Practice Address - Street 1:610 SE 6TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2224
Practice Address - Country:US
Practice Address - Phone:480-881-4555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-18
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health