EVERGREEN CORPORATION (NPI# 1962477737) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962477737 |
| Entity Type | Organization |
| Organization Name | EVERGREEN CORPORATION |
| Other Organization Name | LAKESHORE PHARMACY |
| Practice Address |
134 Central Way Kirkland WA 98033-6106 |
| Practice Telephone | 4258036800 |
| Practice Fax Number | 4258036811 |
| Mailing Telephone | 4258036800 |
| Mailing Fax Number | 4258036811 |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. OLEG ORDINARTSEV (MANAGER) |
| Authorized Official Telephone | 4258036800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | CF58547 | WA | Suppliers |
| Other Name | Type Code |
|---|---|
| Lakeshore Pharmacy | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | EVERGREEN CORPORATION, THE | Gertrude W Brewer, 94 Flagg Road, W Hartford, CT 06117 |
| Street Address |
134 CENTRAL WAY |
| City | KIRKLAND |
| State | WA |
| Zip Code | 98033-6106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912382961 | Vanessa Viloria | Optometrist | 134 Central Way, Kirkland, WA 98033-6106 | 2015-07-20 |
| 1093134397 | Sean Batson | Ophthalmology | 134 Central Way, Kirkland, WA 98033 | 2014-04-15 |
| 1548692114 | Matthew David Callewaert | Optometrist | 134 Central Way, Kirkland, WA 98033-6106 | 2013-08-06 |
| 1346683349 | Joseph I-fine Lee | Optometrist | 134 Central Way, Kirkland, WA 98033 | 2013-04-10 |
| 1265789390 | Mark J Cannon Od Ps | Optometrist | 134 Central Way, Washington Pacific Eye Associates, Kirkland, WA 98033-6106 | 2012-08-08 |
| 1023241312 | Jessica Nadine Lee | Optometrist | 134 Central Way, Kirkland, WA 98033-6106 | 2009-09-02 |
| 1588763494 | Washington Pacific Eye Associates Inc. | Ophthalmology | 134 Central Way, Kirkland, WA 98033-6106 | 2006-09-21 |
| 1609800275 | Jennifer Jung Yun Lee | Ophthalmology | 134 Central Way, Kirkland, WA 98033-6106 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710584826 | Raquel Maria Reyes | Interpreter | 11205 Ne 62nd St., Kirkland, WA 98033 | 2020-10-02 |
| 1588146468 | Lake Washington Family Chiropractic, Pllc | Chiropractor | 816 6th Street South, 816 6th Street South, Kirkland, WA 98033 | 2018-09-06 |
| 1316463557 | Tony Jia Ly | Pharmacist | 7224 120th Ave Ne, Kirkland, WA 98033 | 2017-08-18 |
| 1003356403 | Eden Home Health of King County, LLC | Home Health | 733 7th Avenue, Suite 110, Kirkland, WA 98033 | 2017-03-03 |
| 1184170763 | Kirkland Family Dentistry | Dentist | 1715 Market St #104, Kirkland, WA 98033 | 2016-09-01 |
| 1144688565 | Kamala Psychology and Yoga LLC | Psychologist | 603 4th Ave Ste 101, Kirkland, WA 98033 | 2016-01-30 |
| 1245695352 | Ron Massey | Massage Therapist | 11406 Ne 112th St, Kirkland, WA 98033 | 2015-12-17 |
| 1194106039 | John Pham | Internal Medicine | 9426 116th Ave Ne, Kirkland, WA 98033 | 2015-06-16 |
| 1992199970 | Garrison Patrick Wier | Ophthalmology | 625 4th Ave Ste 301, Kirkland, WA 98033 | 2015-03-26 |
| 1871993113 | Abigail Trajtenberg Loomis | Behavioral Analyst | 1003 7th Avenue, Kirkland, WA 98033 | 2014-08-22 |
| Find all providers in zip 98033 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194760629 | Fred Meyer Stores Inc | Pharmacy | 12221 120th Ave Ne, Kirkland, WA 98034-6905 | 2006-06-18 |
| 1598832412 | Public Hospital District No 2 of King County | Pharmacy | 12303 Ne 130th Ln, Ste 210, Kirkland, WA 98034-3099 | 2006-11-29 |
| 1619089596 | The Bartell Drug Co | Pharmacy | 10625 Ne 68th St, Kirkland, WA 98033-7054 | 2006-08-31 |
| 1518077296 | The Bartell Drug Co | Pharmacy | 14130 Juanita Dr Ne, Kirkland, WA 98034-0127 | 2006-08-30 |
| 1164532842 | The Bartell Drug Co | Pharmacy | 14442 124th Ave Ne, Kirkland, WA 98034-4801 | 2006-08-30 |
| 1144337932 | The Bartell Drug Co | Pharmacy | 6619 132nd Ave Ne, Kirkland, WA 98033-8627 | 2006-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912515644 | Allison Marie Hill | Pharmacy | 3 Spruce Ln, South Bend, WA 98586-9008 | 2020-07-20 |
| 1518504984 | Petersen Investments, LLC | Pharmacy | 12119 Ne 99th St Ste 2030, Vancouver, WA 98682-2461 | 2019-12-04 |
| 1033755731 | Scriptdash Inc | Pharmacy | 13010 Ne 20th St Ste 200, Bellevue, WA 98005-2034 | 2019-11-18 |
| 1063055895 | Rosauers Supermarkets Inc | Pharmacy | 101 S. 47th Avenue, Ridgefield, WA 98642 | 2019-10-24 |
| 1518517101 | The Bartell Drug Co | Pharmacy | 2506 2nd Ave, Seattle, WA 98121-1427 | 2019-09-16 |
| 1457904625 | University of Washington | Pharmacy | 750 Republican St Bldg F, Seattle, WA 98109-4766 | 2019-07-17 |
| 1508348020 | The Bartell Drug Co | Pharmacy | 9010 Market Pl, Lake Stevens, WA 98258-4908 | 2018-08-31 |
| 1144710922 | Healthpoint | Pharmacy | 947 Powell Ave Sw Ste B, Renton, WA 98057-2975 | 2018-05-16 |
| 1093202087 | Sixth Avenue Medical Building Pharmacy | Pharmacy | 508 W 6th Ave Ste 104, Spokane, WA 99204-2701 | 2018-04-16 |
| 1265935795 | The Bartell Drug Co | Pharmacy | 7423 204th St Ne, Arlington, WA 98223-8204 | 2018-03-12 |
| Find all providers with the same taxonomy | ||||
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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.