NPIMap

Organization Active NPI

Wellness PNW, LLC

  • Adult Mental Health Clinic/Center
  • Beaverton, OR
National Provider Identifier
1780272658
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
WELLNESS PNW, LLC
Doing business as
Wellness PNW, LLC
Practice address
16110 SW Regatta LN
Beaverton, OR 97006-8942
Phone
(971) 205-2053
NPI assigned
Jan 6, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Authorized official

Name
Torey Andrus
Title
Owner/Operator
Phone
(858) 603-9904

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

16110 SW Regatta LN
Beaverton, OR 97006-8942

Mailing address

16110 SW Regatta LN
Beaverton, OR 97006-8942
Phone (971) 205-2053

Other names 1

  • Wellness PNW, LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wellness PNW 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.

NPI Registry JSON

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609891200000",
    "number": "1780272658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16110 SW REGATTA LN",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970068942",
            "telephone_number": "971-205-2053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16110 SW REGATTA LN",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970068942",
            "telephone_number": "971-205-2053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS PNW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-06",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A",
        "authorized_official_last_name": "ANDRUS",
        "authorized_official_first_name": "TOREY",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "858-603-9904"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellness PNW, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; 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.