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General NPI Number Information
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NPI Number | 1215746383
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Entity Type | Individual
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Provider Name | MAYA M WILLIAMS PHD
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Gender | Female
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Dates
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Enumeration Date | 01/03/2025
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 205 SE SPOKANE ST STE 300
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City | PORTLAND
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State | OR
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Zip | 97202-6487
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Country | US
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Telephone | 503-877-0711
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Fax |
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Provider Business Mailing Address
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Address Line | 1481 NW 13TH AVE APT 704
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City | PORTLAND
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State | OR
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Zip | 97209-3411
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 3806
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License Number State | OR
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