NPIMap

Organization Active NPI

Recovery Works NW LLC

  • Multi-Specialty Clinic/Center
  • Tigard, OR
National Provider Identifier
1083010094
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
RECOVERY WORKS NW LLC
Practice address
12540 SW Main St Ste 202
Tigard, OR 97223-6198
Phone
(503) 906-9995
Fax
(503) 597-7000
NPI assigned
Nov 18, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Tami McBride
Title
Operations Manager
Phone
(503) 906-9995

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

12540 SW Main St Ste 202
Tigard, OR 97223-6198

Mailing address

12540 SW Main St Ste 202
Tigard, OR 97223
Phone (503) 906-9995

Other practice location 1

173 NE 102nd Ave
Portland, OR 97220-4169
Phone (503) 906-9995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181204003413 OR Part B Supplier - Clinic/Group Practice 5991049835 Receives reassigned benefits from 21 practitioners
Practice locations: Portland, OR; Tigard, OR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2184114Recovery Works NW12540 SW Main St Suite 202, Tigard, OR 97223Certificate of waiverMay 13, 2028

National Provider Directory

National Provider Directory

Locations

173 NE 102nd Ave
#V
Portland, OR 97220

12612 SE Stark St
Bldg M
Portland, OR 97233
Phone (503) 906-9995

16083 SE McLoughlin Blvd
Portland, OR 97267
Phone (503) 906-9995

12540 SW Main St
Ste 202
Tigard, OR 97223
Phone (503) 906-9995

Practitioners & affiliated clinicians

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 48

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629331200000",
    "number": "1083010094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12540 SW MAIN ST STE 202",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "97223",
            "telephone_number": "503-906-9995",
            "fax_number": "503-597-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12540 SW MAIN ST STE 202",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236198",
            "telephone_number": "503-906-9995",
            "fax_number": "503-597-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "173 NE 102nd Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972204169",
            "country_code": "US",
            "telephone_number": "503-906-9995",
            "fax_number": "503-597-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RECOVERY WORKS NW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-18",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-05",
        "status": "A",
        "authorized_official_last_name": "MCBRIDE",
        "authorized_official_first_name": "TAMI",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "503-906-9995",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.