Provider Demographics
NPI:1013259225
Name:ADDICTIONS NORTHWEST, LLC
Entity Type:Organization
Organization Name:ADDICTIONS NORTHWEST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:H
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, CADC III
Authorized Official - Phone:503-836-2228
Mailing Address - Street 1:1141 NE DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-5726
Mailing Address - Country:US
Mailing Address - Phone:503-328-6973
Mailing Address - Fax:503-912-1225
Practice Address - Street 1:1141 NE DIVISION ST
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-5726
Practice Address - Country:US
Practice Address - Phone:503-328-6973
Practice Address - Fax:503-912-1225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-26
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health