Active NPI
Deborah Elaine Johnson Williams, O.D.
- Optometrist
- Forest Grove, OR
National Provider Identifier
1699718536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3151
- Practice address
- 2043 College Way
Forest Grove, OR 97116-1756 - Phone
- (503) 352-2020
- NPI assigned
- Jun 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3151 | OR | Primary |
| Optometrist | 152W00000X | 4414 | MA |
Addresses
Primary practice location
2043 College Way
Forest Grove, OR 97116-1756
Mailing address
3710 SW US Veterans Hospital Dirve
Portland, OR 97239
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3151 | OR | MD | Clinical Psychologist |
| 4414 | MA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187740800000",
"number": "1699718536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3710 SW US VETERANS HOSPITAL DIRVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2043 COLLEGE WAY",
"city": "FOREST GROVE",
"state": "OR",
"postal_code": "971161756",
"telephone_number": "503-352-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "DEBORAH",
"middle_name": "ELAINE JOHNSON",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-14",
"last_updated": "2007-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "3151",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "4414",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Grove, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.