MADRONA RECOVERY WASHINGTON LLC
NPI 1174352975
Psychiatric Residential Treatment Facility in Brush Prairie, WA

NPI Status: Active since July 30, 2024

Contact Information

11910 NE 154TH ST
BRUSH PRAIRIE, WA
ZIP 98606
Phone: (503) 749-2000

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  • Organization
  • Psychiatric Residential Treatment Facili...
  • CLIA Number: 38D2139501
  • CLIA Cert. Type: Other - RESIDENTIAL TREATMENT
  • CLIA Exp. Date: 11-02-2027

About MADRONA RECOVERY WASHINGTON LLC

This page provides the complete NPI Profile along with additional information for Madrona Recovery Washington Llc, a provider established in Brush Prairie, Washington operating as a Psychiatric Residential Treatment Facility. The healthcare provider is registered in the NPI registry with number 1174352975 assigned on July 2024. The practitioner's primary taxonomy code is 323P00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Micah Brady Braithwaite (Cfo/coo)

NPI
1174352975
Provider Name
MADRONA RECOVERY WASHINGTON LLC
Entity Type
Organization
Location Address
11910 NE 154TH ST BRUSH PRAIRIE, WA 98606
Location Phone
(503) 749-2000
Mailing Address
7000 SW VARNS ST PORTLAND, OR 97223
Mailing Phone
(503) 749-0200
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-30-2024
Last Update Date
07-30-2024
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Psychiatric Residential Treatment Facility

Taxonomy Code
323P00000X
Type
Residential Treatment Facilities
Taxonomy Description
A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient's surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1324500000XResidential Treatment Facilities

Substance Abuse Rehabilitation Facility

 

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MICAH BRADY BRAITHWAITE

Authorized Official Title
CFO/COO
Authorized Official Phone
(503) 749-0200

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
38D2139501
Facility Type
Other - RESIDENTIAL TREATMENT
Certificate Effective Date
November 03, 2025
Certificate Expiration Date
November 02, 2027
Laboratory Director
MS. MARY K. HORTON ANP
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Madrona Recovery Washington Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1174352975, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
4
Unchanged
Pos 5
3
Doubled → 6
Pos 6
5
Unchanged
Pos 7
2
Doubled → 4
Pos 8
9
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 3 → 6 2 → 4 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 4 + 4 + 6 + 5 + 4 + 9 + 1 + 4 + 24 = 65

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1174352975.

Other Providers at the Same Location


The following 7 providers are registered at the same or a nearby location.

Counselor (Mental Health)
11910 NE 154TH ST
BRUSH PRAIRIE, WA 98606
Counselor (Mental Health)
11910 NE 154TH ST
BRUSH PRAIRIE, WA 98606
Counselor (Addiction (Substance Use Disorder))
11910 NE 154TH ST
BRUSH PRAIRIE, WA 98606
Counselor (Addiction (Substance Use Disorder))
11910 NE 154TH ST
BRUSH PRAIRIE, WA 98606
Substance Abuse Rehabilitation Facility (Substance Abuse Treatment, Children)
11910 NE 154TH ST
BRUSH PRAIRIE, WA 98606
Counselor (Addiction (Substance Use Disorder))
11910 NE 154TH ST
BRUSH PRAIRIE, WA 98606
Psychiatry & Neurology (Psychiatry)
11910 NE 154TH ST
BRUSH PRAIRIE, WA 98606

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1174352975, enumerated as an "organization" on July 30, 2024.

The provider is located at 11910 NE 154TH ST BRUSH PRAIRIE, WA 98606 and the phone number is (503) 749-2000.

Psychiatric Residential Treatment Facility with taxonomy code 323P00000X.