Pacific Wellness Pathway LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

PACIFIC WELLNESS PATHWAY LLC

Practice address

3085 NE 18TH CT
Gresham, OR 97030-4328

Phone

(813) 385-8389

NPI assigned

Mar 5, 2026

Last updated

Mar 5, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Samirawit Adugna Biratu

Title

Program Administrator

Phone

(813) 385-8389

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1772668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772668800000",
    "number": "1720934482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3085 NE 18TH CT",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970304328",
            "telephone_number": "813-385-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3085 NE 18TH CT",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970304328",
            "telephone_number": "813-385-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC WELLNESS PATHWAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-05",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A",
        "authorized_official_last_name": "BIRATU",
        "authorized_official_first_name": "SAMIRAWIT",
        "authorized_official_middle_name": "ADUGNA",
        "authorized_official_title_or_position": "PROGRAM ADMINISTRATOR",
        "authorized_official_telephone_number": "813-385-8389"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Gresham, OR
• Providers in Gresham, OR by specialty
• Mental Illness Community Based Residential Treatment Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; 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.