Basic Information
| Provider Information | |||||||||
| NPI: | 1609080886 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILLS | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | LOUIS | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3303 SW BOND AVE | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972394501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5034943000 | ||||||||
| FaxNumber: | 5034180843 | ||||||||
| Practice Location | |||||||||
| Address1: | 3303 SW BOND AVE | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972394501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5034943000 | ||||||||
| FaxNumber: | 5034180843 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2007 | ||||||||
| LastUpdateDate: | 07/22/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | MD26999 | OR | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084N0400X | 654661-1205 | UT | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 207WX0109X | MD26999 | OR | Y |
ID Information
| ID | Type | State | Issuer | Description | 278412 | 05 | OR | MEDICAID |