Provider Demographics
NPI:1194027078
Name:NORTHWEST RECOVERY CENTERS LLC
Entity Type:Organization
Organization Name:NORTHWEST RECOVERY CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEBSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-254-2899
Mailing Address - Street 1:5409 100TH ST SW UNIT 39199
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98496-0889
Mailing Address - Country:US
Mailing Address - Phone:425-254-2899
Mailing Address - Fax:425-254-2522
Practice Address - Street 1:2000 BENSON RD S STE 250
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-4454
Practice Address - Country:US
Practice Address - Phone:425-254-2899
Practice Address - Fax:425-254-2899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-25
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health