NPIMap

Organization Active NPI

Ravenseed Azn, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Portland, OR
National Provider Identifier
1912735549
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
RAVENSEED AZN, LLC
Practice address
9570 SW Barbur Blvd Ste 100
Portland, OR 97219-5412
Phone
(971) 232-2234
NPI assigned
Jul 24, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Authorized official

Name
Dr. Asadullah Obaidi, PHARM D
Title
Executive Director
Phone
(402) 304-2502

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

9570 SW Barbur Blvd Ste 100
Portland, OR 97219-5412

Mailing address

1239 SW Ophelia St
Portland, OR 97219-4589
Phone (402) 304-2502

Other practice location 1

504 Main St Ste A
Oregon City, OR 97045-1852
Phone (503) 245-6262

Other names 1

  • Acadia Northwest Doing business as

National Provider Directory

National Provider Directory

Locations

504 Main St
Ste A
Oregon City, OR 97045
Phone (503) 245-6262

9570 SW Barbur Blvd
Ste 100
Portland, OR 97219
Phone (503) 245-6262

Practitioners & affiliated clinicians

Practitioners 7

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": "1721779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1912735549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 SW OPHELIA ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972194589",
            "telephone_number": "402-304-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9570 SW BARBUR BLVD STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972195412",
            "telephone_number": "971-232-2234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "504 Main St Ste A",
            "address_purpose": "LOCATION",
            "city": "Oregon City",
            "state": "OR",
            "postal_code": "970451852",
            "country_code": "US",
            "telephone_number": "503-245-6262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RAVENSEED AZN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "OBAIDI",
        "authorized_official_first_name": "ASADULLAH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "402-304-2502",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Acadia Northwest",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.