Look up the most recent NPI and PECOS records

William Harwell Wilson

Psychiatry & Neurology

Allopathic & Osteopathic Physicians

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

PECOS Enrollment

Based on the most recent information from CMS, provider William Harwell Wilson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1952317448
Provider Type
Individual
Full Name
Wilson, William Harwell
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
8/1/2006
Last Updated
7/8/2007

Contact Information

Practice Location

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

(503) 494-8617

Unlisted Fax

Mailing Location

3635 SW Corbett Ave, Portland, OR 97239-4328

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 2084P0800X Primary	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License MD16139 Oregon

Provider Identifiers

ID	Description	Issuer
ID 062773	Description Medicaid	Issuer Unlisted Oregon

William Harwell Wilson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Chung, Janice

Mack, Joel David

Emens, Jonathan Scott

Wilson, Jonathan

Cheng, Keith Y. M.

Boverman, Joshua Findley

Kinzie, John David

Kesserwani, Christie

Beckley, Ethan

Teo, Alan Robert