Healthcare Provider Details

I. General information

NPI: 1699686923
Provider Name (Legal Business Name): WILLIAM DENMAN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10260 SW GREENBURG RD STE 400
PORTLAND OR
97223-5514
US

IV. Provider business mailing address

PO BOX 2121
SOUTH LONDONDERRY VT
05155-2121
US

V. Phone/Fax

Practice location:
  • Phone: 971-802-1724
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberR10270
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: