Healthcare Provider Details

I. General information

NPI: 1003654120
Provider Name (Legal Business Name): DANICA WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2024
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8625 SW CASCADE AVE STE 520
BEAVERTON OR
97008-7156
US

IV. Provider business mailing address

1711 N GOING ST LOWR
PORTLAND OR
97217-3300
US

V. Phone/Fax

Practice location:
  • Phone: 503-470-1100
  • Fax: 503-214-8029
Mailing address:
  • Phone: 617-899-8783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberA16815
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: