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General NPI Number Information
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NPI Number | 1881513638
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Entity Type | Organization
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Legal Business Name | NORTHWEST SERENITY LLC
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Dates
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Enumeration Date | 07/14/2026
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Last Update Date | 07/14/2026
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Provider Practice Location Address
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Address Line | 373 SE BAKER AVE
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City | GRESHAM
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State | OR
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Zip | 97080-2018
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Country | US
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Telephone | 717-877-7309
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Fax | 717-877-7309
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Provider Business Mailing Address
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Address Line | 373 SE BAKER AVE
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City | GRESHAM
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State | OR
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Zip | 97080-2018
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Country | US
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Telephone | 717-877-7309
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Fax | 717-877-7309
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | GRACE NYIHA WANYOIKE
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Credential | RN
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Telephone | 717-877-7309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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