Organization
RAVENSEED AZN, LLC
Active
Other names
Acadia Northwest
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASADULLAH OBAIDI PHARM D (EXECUTIVE DIRECTOR)
(402) 304-2502
Entity
Organization
Contact information
Practice address
9570 SW BARBUR BLVD STE 100, PORTLAND, OR 97219-5412
(971) 232-2234
Mailing address
1239 SW OPHELIA ST, PORTLAND, OR 97219-4589
(402) 304-2502
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
07/24/2024
Last updated
07/25/2024
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