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Organization
LIFEWORKS NORTHWEST
Active
Organization
LIFEWORKS NORTHWEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY MONNAT MA, LPC, CADCIII (CEO)
(503) 645-3581
Entity
Organization
Contact information
Practice address
5415 SW WESTGATE DRIVE, PORTLAND, OR 97221-2406
(503) 645-3581
(503) 629-8517
Mailing address
5415 SW WESTGATE DRIVE, PORTLAND, OR 97221-2406
(503) 645-3581
(503) 629-8517
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206763
—
OR
Enumeration date
01/22/2009
Last updated
03/09/2022
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