Organization
MADRONA RECOVERY WASHINGTON LLC
Active
Other names
MADRONA RECOVERY WASHINGTON
Organization subpart
No
Provider details
NPI number
Authorized official
MICAH BRADY BRAITHWAITE (CFO/COO)
(503) 749-0200
Entity
Organization
Contact information
Practice address
11910 NE 154TH ST, BRUSH PRAIRIE, WA 98606-9571
(503) 749-2000
Mailing address
7000 SW VARNS ST, PORTLAND, OR 97223-8145
(503) 749-0200
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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