Organization
BYWATER HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES EUGENE WILLIAMSON NP (OWNER)
(504) 434-9164
Entity
Organization
Contact information
Practice address
2119 NE HALSEY ST, PORTLAND, OR 97232-1522
(503) 975-9398
(503) 221-8320
Mailing address
2119 NE HALSEY ST, PORTLAND, OR 97232-1522
(503) 975-9398
(503) 221-8320
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
03/27/2024
Last updated
12/30/2024
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