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EVERGREEN TREATMENT SERVICES
NPI 1417405333
Clinic/Center - Methadone in Renton, WA

Active since September 20, 2016CLIA 50D2116265 · Waiver
1412 SW 43RD ST, SUITE 140, RENTON, WA 98057(425) 264-0750(425) 264-0799 Get Directions Write a Review

NPPES record last updated: April 11, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 11, 2017, Sep 20, 2016 (2 updates tracked since 2016).

About Evergreen Treatment Services NPPES

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

EVERGREEN TREATMENT SERVICES (NPI 1417405333) is a healthcare organization registered as a methadone in Renton, Washington and active in the NPI registry since September 2016. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Margaret Carney, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1417405333
Entity TypeOrganization
Primary Taxonomy261QM2800X
Legal Business NameEVERGREEN TREATMENT SERVICES
Location Address1412 SW 43RD ST, SUITE 140Renton, WA 98057-4803
Mailing Address1700 Airport Way SSeattle, WA 98134-1618 · (206) 223-3644 · Fax (206) 223-1482
Phone(425) 264-0750
Fax(425) 264-0799
Organization SubpartYes
Authorized OfficialMargaret CarneyExecutive Director · (206) 223-3644
Enumeration DateSeptember 20, 2016
Last NPPES UpdateApril 11, 20172 updates tracked since enumeration
✔ NPI 1417405333 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · MethadoneAmbulatory Health Care Facilities
Taxonomy Code261QM2800X
License✔ Licensed in WA · 17 0163 00
Definition
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.
1412 SW 43RD ST, Renton, WA 98057
Open in Google Maps ↗

Other Identifiers 1

Medicaid8008203WA

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 50D2116265

Evergreen Treatment Services · Seattle, WA
Active · expires Apr 4, 2028
CLIA Number50D2116265
Laboratory TypeDrug Treatment
Certificate Effective DateJuly 14, 2022
Certificate Expiration DateApril 4, 2028
Laboratory DirectorPaul G. Grekin
Laboratory Phone(206) 223-3644
Laboratory LocationEvergreen Treatment Services317 S Bennett Street, Seattle, WA 98108
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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.

MR. TIMOTHY STEWART MACP, MDIV, LMHCA
Counselor (Mental Health)
1412 SW 43RD ST, SUITE 111
RENTON, WA 98057
King County (425) 496-4411
GABREIL SANTANA
Technician
1412 SW 43RD ST
RENTON, WA 98057
King County (206) 971-8830
AWA TOURAY
Student in an Organized Health Care Education/Training Program
1412 SW 43RD ST
RENTON, WA 98057
King County (646) 474-1822
EVELYN SPIEKER MN, ARNP
Nurse Practitioner (Women's Health)
1412 SW 43RD ST, SUITE 200
RENTON, WA 98057
King County (425) 271-4910
MR. JAMISON R RIDGELEY MD
Ophthalmology
1412 SW 43RD ST, SUITE 206
RENTON, WA 98057
King County (253) 236-5720
PACIFIC RETINA CENTER PLLC
Ophthalmology (Retina Specialist)
1412 SW 43RD ST
RENTON, WA 98057
King County (910) 742-7427
PAVILLE V. CASTILLO
Counselor
1412 SW 43RD ST
RENTON, WA 98057
King County (425) 264-0750
ASSOCIATED VALLEY COUNSELING, LLC
Counselor (Mental Health)
1412 SW 43RD ST, SUITE 111
RENTON, WA 98057
King County (206) 229-5025

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 Evergreen Treatment Services's NPI number?

The NPI number for Evergreen Treatment Services is 1417405333. It was assigned to this organization in the NPPES registry on September 20, 2016.

Where is Evergreen Treatment Services located?

Evergreen Treatment Services is located at 1412 SW 43rd St Suite 140, Renton, WA 98057. The listed phone number is (425) 264-0750.

What is Evergreen Treatment Services's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Methadone, with taxonomy code 261QM2800X.

Does Evergreen Treatment Services hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2116265) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Evergreen Treatment Services was last updated on April 11, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.