NPIMap

Organization Active NPI

Public Hospital District No 1 of Snohomish County

Doing business as EvergreenHealth Monroe Recovery Center

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Monroe, WA
National Provider Identifier
1770614273
Registry record updated Mar 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Hospital UnitTaxonomy code 276400000X
License
H104 Issued in WA
Legal business name
PUBLIC HOSPITAL DISTRICT NO 1 OF SNOHOMISH COUNTY
Doing business as
EvergreenHealth Monroe Recovery Center
Practice address
17880 147TH Avenue SE
Monroe, WA 98272-1014
Phone
(360) 794-1447
Fax
(360) 794-1493
NPI assigned
Mar 8, 2007
Last updated
Mar 24, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2017

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

Authorized official

Name
Lisa Laplante
Title
Chief Quality Officer
Phone
(360) 794-7497

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Hospital Unit 276400000X H104 WA Primary

Addresses

Primary practice location

17880 147TH Avenue SE
Monroe, WA 98272-1014

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
7034564MedicaidWA

Other names 1

  • EvergreenHealth Monroe Recovery Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080815000228 WA Part A Provider - Hospital 3274426259 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Monroe, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770614273. 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

National Provider Directory

National Provider Directory
Tax ID family
Valley Gen Hospital5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

14729 179TH Ave SE
Monroe, WA

17880 147th St SE
Monroe, WA 98272
Phone (360) 794-1405

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 6

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

Practitioners & affiliated clinicians

Practitioners 43

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 43

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": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490313600000",
    "number": "1770614273",
    "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": "17880 147TH AVENUE SE",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721014",
            "telephone_number": "360-794-1447",
            "fax_number": "360-794-1493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HOSPITAL DISTRICT NO 1 OF SNOHOMISH COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2017-03-24",
        "status": "A",
        "authorized_official_last_name": "LAPLANTE",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CHIEF QUALITY OFFICER",
        "authorized_official_telephone_number": "360-794-7497"
    },
    "taxonomies": [
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "WA",
            "license": "H104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7034564",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EvergreenHealth Monroe Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monroe, WA

Sources for this page

Verify at the official NPI Registry.