Provider Demographics
NPI:1568998763
Name:WATTS, ASHLEY (PHD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:WATTS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13883
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97309-1883
Mailing Address - Country:US
Mailing Address - Phone:971-301-4771
Mailing Address - Fax:971-345-8179
Practice Address - Street 1:2659 COMMERCIAL ST SE STE 282
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4385
Practice Address - Country:US
Practice Address - Phone:971-301-4771
Practice Address - Fax:971-345-8179
Is Sole Proprietor?:No
Enumeration Date:2017-05-08
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2864103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical