Healthcare Provider Details

I. General information

NPI: 1346863461
Provider Name (Legal Business Name): NORTHSTAR TMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2020
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16100 NW CORNELL RD STE 220
BEAVERTON OR
97006-7334
US

IV. Provider business mailing address

65 SW YAMHILL ST STE 300
PORTLAND OR
97204-3316
US

V. Phone/Fax

Practice location:
  • Phone: 800-828-8417
  • Fax: 971-297-1360
Mailing address:
  • Phone: 800-828-8417
  • Fax: 971-297-1360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW WILLIAMS
Title or Position: CEO
Credential: DO
Phone: 480-458-8320