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Organization
R.E.A.P.
Active
Organization
R.E.A.P.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDMOND DESHAWN WILLIAMS MSW (CLINICAL SUPERVISOR)
(503) 334-9955
Entity
Organization
Contact information
Practice address
10814 NE HALSEY ST, PORTLAND, OR 97220-3047
(503) 688-2784
(971) 302-6649
Mailing address
10808 NE HALSEY ST, PORTLAND, OR 97220-3047
(503) 688-2784
(971) 302-6649
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
07/02/2024
Last updated
07/02/2024
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