Bryon Willson, LMT

Primary specialty

Other Specialist/TechnologistTaxonomy code 246Z00000X

License

6631 Issued in OR

Practice address

3350 SW 198TH Ave
Beaverton, OR 97003-2348

Phone

(503) 356-8800

NPI assigned

Jan 25, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Theology

State licenses

Practice roles

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.

• Lilac Wellness

  dba Lilac Wellness and Counseling

  • Multi-Specialty Clinic/Center
  • Salem, OR
  • NPI 1104322841
  NPD (past)

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1285091009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 SW 198TH AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970032348",
            "telephone_number": "504-356-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 SW 198TH AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970032348",
            "telephone_number": "503-356-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLSON",
        "first_name": "BRYON",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-25",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "OR",
            "license": "6631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Renee Williams, OD
• Todd E Williams, M.A., HIS
• Victoria Lynne Williams, RN
• Robin Renee Willins, MSW, LCSW
• Willow Path Recovery LLC
• Christina Lee Wilson, RDH,BSDH
• Jennifer Michelle Wilson, PT, DPT
• Jessica L Wilson, DO
• Nicholas Ryan Wilson, LMT
• Stacey L Wilson, CNM

• Other Specialist/Technologist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Other Specialist/Technologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; 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.