EVERGREENHEALTHCARE (NPI# 1588054332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588054332 |
| Entity Type | Organization |
| Organization Name | EVERGREENHEALTHCARE |
| Practice Address |
12333 Ne 130th Ln Tan 415 Kirkland WA 98034-7467 |
| Practice Telephone | 4258992783 |
| Practice Fax Number | 4258992784 |
| Mailing Telephone | 4258992783 |
| Mailing Fax Number | 4258992784 |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2015-02-02 |
| Authorized Official Name | MARIE A CERMAK (PHARMACIST) |
| Authorized Official Telephone | 4258992783 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
PH0009804 | WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | PHARMACY LICENSE | PH00009804 | 01 |
| Street Address |
12333 NE 130TH LN TAN 415 |
| City | KIRKLAND |
| State | WA |
| Zip Code | 98034-7467 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538169768 | Steven Michael Dawson | Specialist | 12333 Ne 130th Ln, Suite 440, Kirkland, WA 98034-7467 | 2005-07-29 |
| 1003364258 | Kirsten Myhres | Genetic Counselor, MS | 12333 Ne 130th Ln, Tan 240, Kirkland, WA 98034-7467 | 2016-09-16 |
| 1043694185 | King County Public Hospital District No. 2 | Clinic/Center | 12333 Ne 130th Ln, #420, Kirkland, WA 98034-7467 | 2015-07-18 |
| 1285028837 | Rebecca Lewis | Physician Assistant | 12333 Ne 130th Ln, Suite 400, Kirkland, WA 98034-7467 | 2015-03-21 |
| 1427440296 | Marlene Woolf | Pharmacist | 12333 Ne 130th Ln, Tan 415, Kirkland, WA 98034-7467 | 2015-03-03 |
| 1801286810 | Katelin Toshiko Brooks | Pharmacist | 12333 Ne 130th Ln, Tan 415, Kirkland, WA 98034-7467 | 2015-01-28 |
| 1770983108 | Margo Hollenbeck | Pharmacist | 12333 Ne 130th Ln, Kirkland, WA 98034-7467 | 2014-09-04 |
| 1528304292 | Proliance Surgeons, Inc., P.s. | Otolaryngology | 12333 Ne 130th Ln, Suite 440, Kirkland, WA 98034-7467 | 2012-12-27 |
| 1245590637 | Julianna Nadine Walker | Genetic Counselor, MS | 12333 Ne 130th Ln, Suite Tan 240, Kirkland, WA 98034-7467 | 2012-05-21 |
| 1467727198 | Cynthia K Mackenzie | Pharmacist | 12333 Ne 130th Ln, Tan 415, Kirkland, WA 98034-7467 | 2012-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578116596 | Rachel Bowers | Behavior Technician | 1335 Northeast 122nd Way, Suite 105, Kirkland, WA 98034 | 2019-07-18 |
| 1740841048 | Kristina Louise Inghram | Behavior Technician | 11415 Ne 128th St., Suite 40, Kirkland, WA 98034 | 2019-06-26 |
| 1053978064 | Matthew A. Bagnulo, Dds, Ps | Dentist | 11830 Ne 128th St., #202, Kirkland, WA 98034 | 2019-05-24 |
| 1629568928 | Stephanie Michalko | Optometrist | 11800 Ne 128th St Ste 110, Kirkland, WA 98034 | 2018-05-14 |
| 1952800013 | Heath Family Counseling LLC | Marriage & Family Therapist | 12025 115th Ave. Ne, Building D, Ste 200, Kirkland, WA 98034 | 2018-02-05 |
| 1891202834 | Barbara Josephine Gorham | Counselor | 2025 115th Ave Ne, Bldg D, #200, Kirkland, WA 98034 | 2017-12-29 |
| 1548782915 | Eleanor Hollis Wall | Counselor | 14340 102nd Ave Ne, Kirkland, WA 98034 | 2017-07-07 |
| 1457885212 | Peter Schoonmaker | Hospitalist | 12040 Ne 128th Street, Ms105, Kirkland, WA 98034 | 2017-04-18 |
| 1780124370 | Rebecca Managan | Advanced Practice Midwife | 12303 Ne 130th Ln Ste Coral225, Kirkland, WA 98034 | 2017-03-01 |
| 1669821104 | Winter Gonzalez | Counselor | 11720 97th Ln Ne Apt A411, Kirkland, WA 98034 | 2016-06-06 |
| Find all providers in zip 98034 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700098183 | Ali J Naini PC | Clinic/Center | 13107 121st Way Ne Ste A, Kirkland, WA 98034-3051 | 2007-05-05 |
| 1629019500 | Pacmed Clinics | Clinic/Center | 12910 Totem Lake Blvd Ne Ste 101, Kirkland, WA 98034-2901 | 2006-06-09 |
| 1619287281 | Public Hospital District No. 2 | Clinic/Center | 12333 Ne 130th Lane, #320, Kirkland, WA 98034 | 2010-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326676818 | Nocd Washington PC | Clinic/Center | 2320 130th Ave Ne Ste 110, Bellevue, WA 98005-1752 | 2020-03-30 |
| 1922635887 | Cascade Nurse Practitioners | Clinic/Center | 5409 100th St Sw Unit 39800, Lakewood, WA 98496-0970 | 2020-03-23 |
| 1942735667 | The Evergreen At Northpoint | Clinic/Center | 2111 N Northgate Way Ste 101, Seattle, WA 98133-9018 | 2017-05-01 |
| 1174061543 | Antares Wellness Pllc | Clinic/Center | 9319 7th Ave S, Seattle, WA 98108-4604 | 2017-02-06 |
| 1962852038 | Northwest Pain Relief Centers, LLC | Clinic/Center | 503 W Fir St, Suite D, Sequim, WA 98382-3210 | 2016-06-20 |
| 1851741698 | Marconi Chiropractic and Wellness | Clinic/Center | 11207 Mccutcheon Rd, Bonney Lake, WA 98391-8103 | 2016-06-13 |
| 1356738694 | Northwest Pain Relief Centers LLC | Clinic/Center | 7424 Bridgeport Way W Ste 305, Lakewood, WA 98499-8135 | 2015-04-24 |
| 1306231170 | Objective Medical Assessments Corp | Clinic/Center | 401 2nd Ave S, #110, Seattle, WA 98104-3858 | 2015-03-30 |
| 1477946754 | Rose Urgent Care and Family Practice | Clinic/Center | 650 N Devine Rd Ste B, Vancouver, WA 98661-6979 | 2015-03-11 |
| 1336549609 | Ranger Group Pllc | Clinic/Center | 16150 Ne 85th St Ste 110, Redmond, WA 98052-3541 | 2014-08-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.