Active NPI
NW Rresidential Support LLC
- Mental Illness Community Based Residential Treatment Facility
- Portland, OR
National Provider Identifier
1215841358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Community Based Residential Treatment Facility
- Legal business name
- NW RRESIDENTIAL SUPPORT LLC
- Practice address
- 13719 SE Clinton CT
Portland, OR 97236-2859 - Phone
- (503) 826-6790
- NPI assigned
- Sep 28, 2026
- Last updated
- Sep 28, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Wariso Abdi Buta
- Title
- Owner/Ceo
- Phone
- (503) 826-6790
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | NU | Primary |
Addresses
Primary practice location
13719 SE Clinton CT
Portland, OR 97236-2859
Mailing address
13719 SE Clinton CT
Portland, OR 97236-2859
Phone (503) 826-6790
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790553600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790553600000",
"number": "1215841358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13719 SE CLINTON CT",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972362859",
"telephone_number": "503-826-6790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13719 SE CLINTON CT",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972362859",
"telephone_number": "503-826-6790"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NW RRESIDENTIAL SUPPORT LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-28",
"last_updated": "2026-09-28",
"certification_date": "2026-09-23",
"status": "A",
"authorized_official_last_name": "BUTA",
"authorized_official_first_name": "WARISO",
"authorized_official_middle_name": "ABDI",
"authorized_official_title_or_position": "OWNER/CEO",
"authorized_official_telephone_number": "503-826-6790"
},
"taxonomies": [
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
- NW Portland Dental LLC
- NW Portland Holistic Counseling
- NW Portland Tendercare Dental PC
- NW Psychiatric & Mental Health Services (Jean A Daniels)
- NW Residential Support LLC
- NW Spine Management Rehabilitation and Sports Conditioning, Inc (Sports Injury Management)
- NW Surgical Oncology PC
- Vanessa N Nwaokocha, MD
- Pawsay Nwee
- Ijeoma Chinwe Nwerem, FNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.