1. Home
  2. Directory
  3. Washington
  4. Monroe
  5. Clinic Center
  6. NPI Profile

CONQUER
NPI 1255001624
Clinic/Center - Multi-Specialty in Monroe, WA

Active since September 17, 2021CLIA 50D2331135 · Waiver
809 W MAIN ST STE C, MONROE, WA 98272(206) 552-0882(844) 440-2147 Get Directions Write a Review

NPPES record last updated: October 11, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 11, 2024, Jun 26, 2024, Jun 12, 2024 and 2 more (5 updates tracked since 2021).

About Conquer NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CONQUER (NPI 1255001624) is a healthcare organization registered as a multi-specialty in Monroe, Washington and active in the NPI registry since September 2021. The organization holds a CLIA Waiver certificate valid through April 4, 2028, maintains a secondary practice location in Oak Harbor, and lists Jacob Grillo, Ceo, as its authorized official.

NPPES Registry Identity

NPI1255001624
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameCONQUER ADDICTION PLLC
Location Address809 W MAIN ST STE CMonroe, WA 98272-2172
Mailing Address809 W Main St Ste CMonroe, WA 98272-2172 · (206) 552-0882
Phone(206) 552-0882
Fax(844) 440-2147
Organization SubpartNo
Authorized OfficialJacob GrilloCeo · (425) 387-1863
Enumeration DateSeptember 17, 2021
Last NPPES UpdateOctober 11, 20245 updates tracked since enumeration
NPPES CertifiedOctober 11, 2024
✔ NPI 1255001624 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 8

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X
Also ListedCase ManagementTaxonomy 251B00000X
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
Also ListedClinic/CenterTaxonomy 261Q00000X
Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X
Also ListedClinic/Center · Urgent CareTaxonomy 261QU0200X
Also ListedTaxiTaxonomy 344600000X
809 W MAIN ST STE C, Monroe, WA 98272
Open in Google Maps ↗

Other Names 1

Doing Business AsConquer

Secondary Practice Location 1

Location 1791 SE Barrington DrOak Harbor, WA 98277-3278 · Phone (206) 552-0882

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Premera Blue Cross Blue Shield of Alaska.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Conquer is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Conquer, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (7)

Ambyr Berman, MACP
Mental Health Counselor
NPI 1336523992
809 W MAIN ST STE C
Monroe, WA 98272
(206) 552-0882
✔ PECOS✔ Accepts MedicareSame address
Robert Mccullough, LMHC, SUDP
Mental Health Counselor
NPI 1386006922
809 W MAIN ST STE C
Monroe, WA 98272
(206) 552-0882
✔ PECOS✔ Accepts MedicareSame address
Michael Black
Nurse Practitioner
NPI 1750858072
901 RAINIER AVE S
Seattle, WA 98144
(206) 470-3880
✔ PECOS24 mi
Calvin Cogburn, ARNP
Nurse Practitioner
NPI 1184764284
1155 SE CITY BEACH ST UNIT 915
Oak Harbor, WA 98277
(360) 969-0915
✔ PECOS✔ Accepts Medicare43 mi
Geoffrey Godfrey, FNP-C
Nurse Practitioner
NPI 1689610925
19636 N 27TH AVE STE 190
Phoenix, AZ 85027
(623) 516-8252
✔ PECOS✔ Accepts Medicare1,105 mi
Sara Mazzoni, MD
Obstetrics/Gynecology
NPI 1235285842
4701 SANGAMORE RD STE N100
Bethesda, MD 20816
(914) 919-9200
✔ PECOS2,305 mi
Thomas Robey, M.D., PH.D.
Emergency Medicine
NPI 1942434675
20 YORK ST # T-209 YALE-NEW HAVEN HOSPITAL
New Haven, CT 06510
(203) 688-2259
✔ PECOS✔ Accepts Medicare2,420 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D2331135

Conquer · Puyallup, WA
Active · expires Apr 4, 2028
CLIA Number50D2331135
Laboratory TypeCity Jail
Certificate Effective DateSeptember 26, 2025
Certificate Expiration DateApril 4, 2028
Laboratory DirectorJacob Grillo
Laboratory Phone(206) 552-0882
Laboratory LocationConquer311 W Pioneer, Room 01, Puyallup, WA 98371
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Conquer Addiction PLLC's NPI number?

The NPI number for Conquer Addiction PLLC is 1255001624. It was assigned to this organization in the NPPES registry on September 17, 2021. The provider is doing business as Conquer.

Where is Conquer Addiction PLLC located?

Conquer Addiction PLLC is located at 809 W Main St Ste C, Monroe, WA 98272. The listed phone number is (206) 552-0882.

What is Conquer Addiction PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Is Conquer Addiction PLLC enrolled in Medicare?

Yes. Conquer Addiction PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Conquer Addiction PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 4 Medicare specialties reassign their Medicare billing to Conquer Addiction PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (3), Mental Health Counselor (2) and Emergency Medicine (1). Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Conquer Addiction PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2331135) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Conquer Addiction PLLC accept?

Health plans from Ambetter Health and Premera Blue Cross Blue Shield of Alaska list Conquer Addiction PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Conquer Addiction PLLC was last updated on October 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.