Provider Demographics
NPI:1558153023
Name:NW SERENITY ADULT FAMILY HOME
Entity type:Organization
Organization Name:NW SERENITY ADULT FAMILY HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAMINTA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRADALE
Authorized Official - Suffix:
Authorized Official - Credentials:HOME CARE AIDE
Authorized Official - Phone:360-513-5987
Mailing Address - Street 1:1407 SE 196TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-9547
Mailing Address - Country:US
Mailing Address - Phone:360-513-5987
Mailing Address - Fax:
Practice Address - Street 1:7418 SE EVERGREEN HWY
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-1718
Practice Address - Country:US
Practice Address - Phone:564-258-9740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty