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Organization

MADRONA RECOVERY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICAH BRADY BRAITHWAITE (COO/CFO)
(503) 749-0200
Entity
Organization

Contact information

Practice address
7000 SW VARNS ST, TIGARD, OR 97223-8145
(949) 293-2351
Mailing address
7000 SW VARNS ST, TIGARD, OR 97223-8145
(503) 749-0200

Taxonomy

Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
324500000X
Substance Abuse Rehabilitation Facility
OR

Other

Enumeration date
04/05/2017
Last updated
06/20/2019
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