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General NPI Number Information
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NPI Number | 1194027078
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Entity Type | Organization
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Legal Business Name | NORTHWEST RECOVERY CENTERS LLC
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Dates
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Enumeration Date | 11/25/2010
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Last Update Date | 04/13/2022
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Provider Practice Location Address
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Address Line | 2000 BENSON RD S STE 250
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City | RENTON
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State | WA
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Zip | 98055-4454
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Country | US
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Telephone | 425-254-2899
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Fax | 425-254-2899
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Provider Business Mailing Address
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Address Line | 5409 100TH ST SW UNIT 39199
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City | LAKEWOOD
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State | WA
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Zip | 98496-0889
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Country | US
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Telephone | 425-254-2899
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Fax | 425-254-2522
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL A WEBSTER
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Credential |
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Telephone | 425-254-2899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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