NPIMap

Organization Active NPI

Stillaguamish Tribe of Indians

Doing business as Iccs

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Arlington, WA
National Provider Identifier
1790826600
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
STILLAGUAMISH TRIBE OF INDIANS
Doing business as
Iccs
Island Crossing Counseling Services
Practice address
5700 172ND St NE # a
Arlington, WA 98223-7742
Phone
(360) 652-9640
Fax
(360) 652-2093
NPI assigned
Feb 12, 2007
Organization subpart
Yes
Parent organization
STILLAGUAMISH TRIBE OF INDIANSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Authorized official

Name
Krista Yandle
Title
Billing Supervisor
Phone
(360) 652-9640

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X
Methadone Clinic 261QM2800X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

5700 172ND St NE # a
Arlington, WA 98223-7742

Mailing address

5700 172ND St NE # a
Arlington, WA 98223-7742
Phone (360) 652-9640

Other identifiers 1

IdentifierTypeStateIssuer
1994565MedicaidWA

Other names 2

  • ICCS Doing business as
  • Island Crossing Counseling Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Opioid treatment program
Medicare-enrolled since Mar 27, 2025

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250508003210 TX Part B Supplier - Opioid Treatment Program (Otp) 9638278435 Practice locations: Arlington, WA

National Provider Directory

National Provider Directory
Tax ID family
Stillaguamish Tribe of Indians11 organizations share this tax ID, including this one
Part of
Stillaguamish Tribe of Indians

Other organizations with this tax ID 9

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

Locations

5700 172nd St NE
#A
Arlington, WA 98223
Phone (360) 572-3499

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787616000000",
    "number": "1790826600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 172ND ST NE # A",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982237742",
            "telephone_number": "360-652-9640",
            "fax_number": "360-652-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 172ND ST NE # A",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982237742",
            "telephone_number": "360-652-9640",
            "fax_number": "360-652-2093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILLAGUAMISH TRIBE OF INDIANS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STILLAGUAMISH TRIBE OF INDIANS",
        "enumeration_date": "2007-02-12",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A",
        "authorized_official_last_name": "YANDLE",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "360-652-9640"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1994565",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ICCS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Island Crossing Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Island Crossing Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.