NPIMap

Organization Active NPI

Avalon Wellness Living LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Tigard, OR
National Provider Identifier
1174321657
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
AVALON WELLNESS LIVING LLC
Practice address
13205 SW Watkins Ave
Tigard, OR 97223-3870
Phone
(503) 740-4522
Fax
(971) 246-5082
NPI assigned
Mar 3, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Authorized official

Name
Rahel Masresha
Title
Administrator
Phone
(503) 740-4522

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Assisted Living Facility (Mental Illness) 3104A0625X
Mental Illness Community Based Residential Treatment Facility 320800000X Primary
Psychiatric Residential Treatment Facility 323P00000X

Addresses

Primary practice location

13205 SW Watkins Ave
Tigard, OR 97223-3870

Mailing address

13205 SW Watkins Ave
Tigard, OR 97223-3870

National Provider Directory

National Provider Directory
Tax ID family
Avalon Wellness Living LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1740960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755648000000",
    "number": "1174321657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13205 SW WATKINS AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972233870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13205 SW WATKINS AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972233870",
            "telephone_number": "503-740-4522",
            "fax_number": "971-246-5082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON WELLNESS LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-03",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A",
        "authorized_official_last_name": "MASRESHA",
        "authorized_official_first_name": "RAHEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "503-740-4522"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "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 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.