Provider Demographics
NPI:1467133280
Name:RECOVERY WORKS NW LLC
Entity Type:Organization
Organization Name:RECOVERY WORKS NW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:TAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:MCBRIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-840-7564
Mailing Address - Street 1:12122 SE FOSTER RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97266-4043
Mailing Address - Country:US
Mailing Address - Phone:503-906-9995
Mailing Address - Fax:
Practice Address - Street 1:12122 SE FOSTER RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-4043
Practice Address - Country:US
Practice Address - Phone:503-906-9995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RECOVERY WORKS NW LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Single Specialty