Provider Demographics
NPI:1801932603
Name:WILLIAMS, DOWELL R JR (MS)
Entity type:Individual
Prefix:MR
First Name:DOWELL
Middle Name:R
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11735 SW SWENDON LOOP
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-1594
Mailing Address - Country:US
Mailing Address - Phone:503-590-0103
Mailing Address - Fax:
Practice Address - Street 1:5725 NE PRESCOTT ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97218-2229
Practice Address - Country:US
Practice Address - Phone:503-402-8103
Practice Address - Fax:503-249-9510
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health