Evergreen Opco LLC

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

Legal business name

EVERGREEN OPCO LLC

Practice address

3760 N Clarey St
Eugene, OR 97402-8744

Phone

(541) 607-9525

NPI assigned

Jan 13, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Trevor Wart

Title

Manager

Phone

(503) 706-6918

Specialties & licenses 1

Addresses

Other names 1

• Evergreen senior living community; Evergreen memory care community Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1736726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736726400000",
    "number": "1003626862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 LAKEVIEW BLVD",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838641120",
            "telephone_number": "503-706-6918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 N CLAREY ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974028744",
            "telephone_number": "541-607-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A",
        "authorized_official_last_name": "WART",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-706-6918",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen senior living community; Evergreen memory care community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kyle Lucan Evans, PSS
• Mark B Evans, PH.D.
• Renee Jessica Evans
• Savannah Philips Ross Evans
• Evergreen Eyewear
• Evergreen Therapy LLC
• Iryna V Ewbank
• James A Ewell, PH.D.
• James Alfred Ewell Jr.
• Shalamar Ewing

• Custodial Care Facility in Eugene, OR
• Providers in Eugene, OR by specialty
• Custodial Care Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.