| Recovery Works Nw Llc | |
|
12540 Sw Main St Ste 202 Tigard OR 97223-6198 | |
| (503) 906-9995 | |
| (503) 597-7000 |
| Full Name | Recovery Works Nw Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 12540 Sw Main St Ste 202, Tigard, Oregon |
| Authorized Official Name and Position | Tami Mcbride (OPERATIONS MANAGER) |
| Authorized Official Contact | 5039069995 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Recovery Works Nw Llc 12540 Sw Main St Ste 202 Tigard OR 97223 Ph: (503) 906-9995 | Recovery Works Nw Llc 12540 Sw Main St Ste 202 Tigard OR 97223-6198 Ph: (503) 906-9995 |
| NPI Number | 1083010094 |
|---|---|
| Provider Enumeration Date | 11/18/2014 |
| Last Update Date | 08/19/2021 |
| Medicare PECOS PAC ID | 5991049835 |
|---|---|
| Medicare Enrollment ID | O20181204003413 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083010094 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Secondary |
| Provider Name | Virginia L Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043247059 PECOS PAC ID: 6901846468 Enrollment ID: I20050504000970 |
| Provider Name | Merle D Williamson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1467465823 PECOS PAC ID: 1456433523 Enrollment ID: I20080128000759 |
| Provider Name | Peter A Grover |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730260951 PECOS PAC ID: 3870660905 Enrollment ID: I20080916000156 |
| Provider Name | Christine D Gray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932344199 PECOS PAC ID: 0547431348 Enrollment ID: I20110928000423 |
| Provider Name | Benjamin J Schwartz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275565244 PECOS PAC ID: 9436182268 Enrollment ID: I20120104000858 |
| Provider Name | Bryan Schwartz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396060331 PECOS PAC ID: 2365677606 Enrollment ID: I20150126001016 |
| Provider Name | Terena D Gimmillaro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235574955 PECOS PAC ID: 5395970214 Enrollment ID: I20150908001807 |
| Provider Name | Elizabeth A Britain |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1801840426 PECOS PAC ID: 6800046624 Enrollment ID: I20161108001703 |
| Provider Name | Ilana Hull |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124439039 PECOS PAC ID: 5395960678 Enrollment ID: I20170807001636 |
| Provider Name | Faith Purvis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669032975 PECOS PAC ID: 5193051431 Enrollment ID: I20190724004090 |
| Provider Name | Cydney W Heims |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619383403 PECOS PAC ID: 2961794458 Enrollment ID: I20190808003391 |
| Provider Name | Marc F Chinard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174679682 PECOS PAC ID: 9739515396 Enrollment ID: I20200218002148 |
| Provider Name | Ellen Mooney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528417169 PECOS PAC ID: 4486949666 Enrollment ID: I20211027001824 |
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