NPIMap

Organization Active NPI

Public Hospital District 1 of Snohomish County

Doing business as EvergreenHealth Monroe

  • General Acute Care Hospital
  • Monroe, WA
National Provider Identifier
1013074061
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
H-104 Issued in WA
Legal business name
PUBLIC HOSPITAL DISTRICT 1 OF SNOHOMISH COUNTY
Doing business as
EvergreenHealth Monroe
Practice address
14701 179TH Ave SE
Monroe, WA 98272-1108
Phone
(360) 794-1447
Fax
(360) 794-1486
NPI assigned
Jan 2, 2007
Last updated
Aug 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Authorized official

Name
Lisa M. Laplante
Title
Chief Administrative Officer
Phone
(360) 794-7497

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X H-104 WA Primary

Addresses

Primary practice location

14701 179TH Ave SE
Monroe, WA 98272-1108

Mailing address

14701 179TH Ave SE
Monroe, WA 98272-1108
Phone (360) 794-1447

Other identifiers 1

IdentifierTypeStateIssuer
7034564MedicaidWA

Other names 1

  • EvergreenHealth Monroe Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040204000272 WA Part B Supplier - Clinic/Group Practice 3274426259 Receives reassigned benefits from 29 practitioners
Practice locations: Monroe, WA
O20080815000228 WA Part A Provider - Hospital 3274426259 1 other NPI on this enrollment
Practice locations: Monroe, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013074061. Details of each certification follow.

Hospital certification: CCN 500084

Legal name
PUBLIC HOSPITAL DISTRICT 1 OF SNOHOMISH COUNTY
Doing business as
EVERGREEN HEALTH MONROE
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jan 8, 2026
Beds
72
Ownership / control type
Hospital district or authority
Organization structure
OtherNon-profit
Enrollment address
14701 179TH Ave SE
Monroe, WA 98272-1108
Hospital subgroups
General

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Evergreenhealth MonroeCCN 500084 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D0690275Evergreen Health Monroe14701 179TH Ave SE, Monroe, WA 98272ComplianceApr 4, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ann Peterson Individual Corporate OfficerFinancial Officer Apr 1, 2022
Public Hospital District 1 of Snohomish County Organization, Monroe, WA 5% Or Greater Direct Ownership Interest Jun 22, 2009
Alice Cabe Individual Corporate Director Jun 22, 2009
King County Public Hospital District No 2 Organization, Kirkland, WA Operational/Managerial Control Mar 1, 2015 100%
Lisa M Laplante Individual Corporate OfficerChief Administrative Officer Jul 1, 2019
Operational/Managerial ControlChief Administrative Officer Jul 1, 2019

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 41

Affiliated clinicians 338

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 338

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629331200000",
    "number": "1013074061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14701 179TH AVE SE",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721108",
            "telephone_number": "360-794-1447",
            "fax_number": "360-794-1486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14701 179TH AVE SE",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721108",
            "telephone_number": "360-794-1447",
            "fax_number": "360-794-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HOSPITAL DISTRICT 1 OF SNOHOMISH COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A",
        "authorized_official_last_name": "LAPLANTE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "360-794-7497"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "WA",
            "license": "H-104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7034564",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EvergreenHealth Monroe",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EvergreenHealth Monroe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monroe, WA

Sources for this page

Verify at the official NPI Registry.