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Organization

CONQUER ADDICTION PLLC

Active
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Organization

CONQUER ADDICTION PLLC

Active
Other names
CONQUER
Organization subpart
No

Provider details

NPI number
Authorized official
JACOB GRILLO MBA, PA-C (CEO)
(425) 387-1863
Entity
Organization

Contact information

Practice address
809 W MAIN ST STE C, MONROE, WA 98272-2172
(206) 552-0882
(844) 440-2147
Mailing address
809 W MAIN ST STE C, MONROE, WA 98272-2172
(206) 552-0882

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
261Q00000X
Clinic/Center
261QM0850X
Adult Mental Health Clinic/Center
261QM1300X
Multi-Specialty Clinic/Center
Primary
261QU0200X
Urgent Care Clinic/Center
344600000X
Taxi

Other

Enumeration date
09/17/2021
Last updated
10/11/2024
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