Healthcare Provider Details

I. General information

NPI: 1578669339
Provider Name (Legal Business Name): STEPHANIE WILLIAMS MSW,LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8215 SW TUALATIN SHERWOOD RD STE 200
TUALATIN OR
97062-8620
US

IV. Provider business mailing address

1229 N CREEKSIDE LN
NEWBERG OR
97132-5605
US

V. Phone/Fax

Practice location:
  • Phone: 503-899-3793
  • Fax:
Mailing address:
  • Phone: 541-398-0577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL4240
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: