Evergreen Cardiology Care Center

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

EVERGREEN CARDIOLOGY CARE CENTER

Practice address

8301 161St Ave NE
Suite 302
Redmond, WA 98052-3858

Phone

(800) 243-5854

Fax

(206) 824-9510

NPI assigned

May 18, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Dennis M Enomoto, MDNPI 1649226127

Title

President/Owner

Phone

(425) 882-4700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Evergreen Cardiology Clinic, PS Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dennis M Enomoto, MD

  • Cardiovascular Disease Physician
  • Twin Falls, ID
  • NPI 1649226127
  NPD (past) Authorized official

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023061553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13684",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981981010",
            "telephone_number": "800-243-5854",
            "fax_number": "206-824-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 161ST AVE NE",
            "address_2": "SUITE 302",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523858",
            "telephone_number": "800-243-5854",
            "fax_number": "206-824-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN CARDIOLOGY CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ENOMOTO",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "425-882-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1086495",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Cardiology Clinic, PS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Cassandra Espinoza, LMP
• Constance Essinger, M.ED.
• Evans Creek Counseling Professional Limited Liability Company
• David E Evans, LMHC
• Everglow Home Care
• Evergreen Electrolysis LLC
• Evergreen Hearing Clinic Inc
• Evergreen Speech Clinic, Inc
• Dagmar H Evers, PT
• Carley Ewert, LMP

• Specialist in Redmond, WA
• Providers in Redmond, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.