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
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500621571
—
OR
Enumeration date
09/16/2010
Last updated
03/09/2022
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