Individual provider Active NPI

Raheem Jahmel Watson, PWS

  • Case Manager/Care Coordinator
  • Portland, OR
National Provider Identifier
1205663739
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
610 SE 6TH Ave
Portland, OR 97214-2224
Phone
(480) 881-4555
NPI assigned
Sep 18, 2024
Last updated
Jun 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

610 SE 6TH Ave
Portland, OR 97214-2224

Mailing address

610 SE 6TH Ave
Portland, OR 97214-2224
Phone (480) 881-4555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rose City Recovery CurrentSince Sep 1, 2024 Accepting new patients

Locations

610 SE 6th Ave
Portland, OR 97214
Phone (480) 881-4555

80 SE Madison St
Ste 210
Portland, OR 97214
Phone (503) 442-9917

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1205663739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 SE 6TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142224",
            "telephone_number": "480-881-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 SE 6TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142224",
            "telephone_number": "480-881-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "RAHEEM",
        "middle_name": "JAHMEL",
        "credential": "PWS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-18",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.