Provider Demographics
NPI:1225710973
Name:WILLIAMS, RAYA (LM, CPM)
Entity type:Individual
Prefix:
First Name:RAYA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 FRANKFORT AVE
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-7756
Mailing Address - Country:US
Mailing Address - Phone:206-476-6035
Mailing Address - Fax:
Practice Address - Street 1:405 FRANKFORT AVE
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-7756
Practice Address - Country:US
Practice Address - Phone:206-476-6035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174N00000X
WI522-49176B00000X
IL295.000024176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No174N00000XOther Service ProvidersLactation Consultant, Non-RN