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HAZELWOOD HOUSE
NPI 1508090994
Community Based Residential Treatment Facility, Mental Illness in Portland, OR

Active since May 13, 2009
5415 SW WESTGATE DR, PORTLAND, OR 97221(503) 645-3581(503) 629-8517 Get Directions Write a Review

NPPES record last updated: March 9, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Hazelwood House NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HAZELWOOD HOUSE (NPI 1508090994) is a healthcare organization registered as a community based residential treatment facility, mental illness in Portland, Oregon and active in the NPI registry since May 2009. The organization lists Mary Monnat, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1508090994
Entity TypeOrganization
Primary Taxonomy320800000X
Legal Business NameHAZELWOOD HOUSE
Location Address5415 SW WESTGATE DRPortland, OR 97221-2409
Mailing Address5415 Sw Westgate DrPortland, OR 97221-2409 · (503) 645-3581 · Fax (503) 629-8517
Phone(503) 645-3581
Fax(503) 629-8517
Organization SubpartYesParent: Lifeworks Northwest
Authorized OfficialMary MonnatPresident/ceo · (503) 645-3581
Enumeration DateMay 13, 2009
Last NPPES UpdateMarch 9, 2022
NPPES CertifiedMarch 9, 2022
✔ NPI 1508090994 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Mental IllnessResidential Treatment Facilities
Taxonomy Code320800000X
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
5415 SW WESTGATE DR, Portland, OR 97221
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Other Identifiers 1

Medicaid512881OR

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAWDAH MOHAMMED HEGAZY
Student in an Organized Health Care Education/Training Program
5415 SW WESTGATE DR
PORTLAND, OR 97221
Multnomah County (503) 645-3581
SKYLER M BJORKLUND LMSW
Counselor
5415 SW WESTGATE DR
PORTLAND, OR 97221
Multnomah County (503) 645-3581
MUBARIG JAMA
Case Manager/Care Coordinator
5415 SW WESTGATE DR
PORTLAND, OR 97221
Multnomah County (503) 645-3681
SARAH JULIA SPERGEL
Counselor
5415 SW WESTGATE DR
PORTLAND, OR 97221
Multnomah County (503) 645-3581
DANIEL GRABOWSKY
Peer Specialist
5415 SW WESTGATE DR
PORTLAND, OR 97221
Multnomah County (503) 645-3581
HANNAH LEE SMARGIASSI
Student in an Organized Health Care Education/Training Program
5415 SW WESTGATE DR
PORTLAND, OR 97221
Multnomah County (971) 278-3173
RAMA MAHROUS
Case Manager/Care Coordinator
5415 SW WESTGATE DR
PORTLAND, OR 97221
Multnomah County (503) 645-3581
COLLEEN THOMPSON
Case Manager/Care Coordinator
5415 SW WESTGATE DR
PORTLAND, OR 97221
Multnomah County (503) 645-3581

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Hazelwood House's NPI number?

The NPI number for Hazelwood House is 1508090994. It was assigned to this organization in the NPPES registry on May 13, 2009.

Where is Hazelwood House located?

Hazelwood House is located at 5415 SW Westgate Dr, Portland, OR 97221. The listed phone number is (503) 645-3581.

What is Hazelwood House's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.

When was this NPI record last updated?

The NPPES record for Hazelwood House was last updated on March 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.