EVERGREEN RECOVERY CENTERS-HEALTH SERVICES
NPI 1275297384
Nurse Practitioner - Primary Care in Lynwood, WA

Q: What is Evergreen Recovery Centers-Health Services's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Active since October 25, 2021CLIA 50D2210721 · Waiver

20508 56TH AVE W, LYNWOOD, WA 98036(425) 535-4243(425) 835-0960 Get Directions Write a Review

NPPES record last updated: September 9, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 9, 2025, May 16, 2025 (2 updates tracked since 2025).

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About Evergreen Recovery Centers-health Services NPPES

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

EVERGREEN RECOVERY CENTERS-HEALTH SERVICES (NPI 1275297384) is a healthcare organization registered as a primary care in Lynwood, Washington and active in the NPI registry since October 2021. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Kathy L Kain, Cqo, as its authorized official.

NPPES Registry Identity

NPI1275297384

Entity TypeOrganization

Primary Taxonomy363LP2300X

Legal Business NameEVERGREEN RECOVERY CENTERS-HEALTH SERVICES

Location Address20508 56TH AVE WLynwood, WA 98036

Mailing AddressPo Box 12598Everett, WA 98206 · (425) 493-5310 · Fax (425) 263-9706

Phone(425) 535-4243

Fax(425) 835-0960

Organization SubpartNo

Authorized OfficialKathy L KainCqo · (425) 343-4599

Enumeration DateOctober 25, 2021

Last NPPES UpdateSeptember 9, 20252 updates tracked since enumeration

NPPES CertifiedSeptember 9, 2025

✔ NPI 1275297384 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP2300X

Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X

Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X

20508 56TH AVE W, Lynwood, WA 98036

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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 50D2210721

Evergreen Recovery Centers · Lynnwood, WA

Active · expires Apr 4, 2028

CLIA Number50D2210721

Laboratory TypeDrug Treatment

Certificate Effective DateJanuary 22, 2021

Certificate Expiration DateApril 4, 2028

Laboratory DirectorEileen Newton

Laboratory Phone(425) 535-4243

Laboratory LocationEvergreen Recovery Centers20508 56th Ave W Ste 104, Lynnwood, WA 98036

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISHELE M RUTHERFORD ARNP

Nurse Practitioner (Psychiatric/Mental Health)