Organization
PACIFIC WELLNESS PATHWAY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMIRAWIT ADUGNA BIRATU (PROGRAM ADMINISTRATOR)
(813) 385-8389
Entity
Organization
Contact information
Practice address
3085 NE 18TH CT, GRESHAM, OR 97030-4328
(813) 385-8389
Mailing address
3085 NE 18TH CT, GRESHAM, OR 97030-4328
(813) 385-8389
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/05/2026
Last updated
03/05/2026
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