NPIMap

Organization Active NPI

Evergreen Recovery Centers

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Everett, WA
National Provider Identifier
1124159157
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
31 1095 00 Issued in WA
Legal business name
EVERGREEN RECOVERY CENTERS
Practice address
2732 Grand Ave Ste 101
Everett, WA 98201-3416
Phone
(425) 259-5842
Fax
(425) 339-2601
NPI assigned
Mar 9, 2007
Organization subpart
Yes
Parent organization
EVERGREEN RECOVERY CENTERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Authorized official

Name
Kathy L Kain
Title
Chief Quality Officer
Phone
(425) 343-4599

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 31 1095 00 WA Primary

Addresses

Primary practice location

2732 Grand Ave Ste 101
Everett, WA 98201-3416

Mailing address

PO Box 12598
Everett, WA 98206
Phone (425) 258-2407

Other identifiers 1

IdentifierTypeStateIssuer
1990746MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
Evergreen Recovery Centers-Health Services7 organizations share this tax ID, including this one
Part of
Evergreen Recovery Centers-Health Services

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2932 Hoyt Ave
Everett, WA 98201

2732 Grand Ave
#101
Everett, WA 98201
Phone (425) 259-5842

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1124159157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12598",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98206",
            "telephone_number": "425-258-2407",
            "fax_number": "425-339-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2732 GRAND AVE STE 101",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013416",
            "telephone_number": "425-259-5842",
            "fax_number": "425-339-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN RECOVERY CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVERGREEN RECOVERY CENTERS",
        "enumeration_date": "2007-03-09",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A",
        "authorized_official_last_name": "KAIN",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF QUALITY OFFICER",
        "authorized_official_telephone_number": "425-343-4599"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "WA",
            "license": "31 1095 00",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1990746",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; 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.