Individual
LARRY C WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADCI
Contact information
Practice address
1949 SE 122ND AVE, PORTLAND, OR 97233-1303
(503) 253-5954
(503) 253-4643
Mailing address
232 NW 6TH AVE, ATTN: BBIS CREDENTIALING, PORTLAND, OR 97209-3609
(503) 501-5641
(503) 241-7419
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16-P-07
OR
Other
Enumeration date
07/07/2017
Last updated
07/07/2017
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