Organization
LIFE WORKS NORTHWEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL LYNN GRAVES (MENTOR)
(503) 856-4571
Entity
Organization
Contact information
Practice address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
(503) 856-4571
Mailing address
14600 NW CORNELL RD, PORTLAND, OR 97229
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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