Organization
AVALON WELLNESS LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAHEL MASRESHA (ADMINISTRATOR)
(503) 740-4522
Entity
Organization
Contact information
Practice address
13205 SW WATKINS AVE, TIGARD, OR 97223-3870
(503) 740-4522
(971) 246-5082
Mailing address
13205 SW WATKINS AVE, TIGARD, OR 97223-3870
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Enumeration date
03/03/2025
Last updated
08/20/2025
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