NPIMap

Organization Active NPI

NW Evergreen Chiropractic P.C.

  • Chiropractor
  • Vancouver, WA
National Provider Identifier
1154018752
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
NW EVERGREEN CHIROPRACTIC P.C.
Practice address
16703 SE McGillivray Blvd Ste 175
Vancouver, WA 98683-4301
Phone
(360) 818-8508
NPI assigned
Apr 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Authorized official

Name
Dr. Cassandra Long, DCNPI 1093119455
Title
Owner
Phone
(206) 604-8968

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

16703 SE McGillivray Blvd Ste 175
Vancouver, WA 98683-4301

Mailing address

16703 SE McGillivray Blvd Ste 175
Vancouver, WA 98683-4301
Phone (360) 818-8508

Other practice location 1

404 E Main St
Battle Ground, WA 98604-8506
Phone (360) 818-8508

Other names 1

  • Evergreen Chiropractic Doing business as

National Provider Directory

National Provider Directory

Locations

404 E Main St
Battle Ground, WA 98604
Phone (360) 687-0800

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1154018752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16703 SE MCGILLIVRAY BLVD STE 175",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834301",
            "telephone_number": "360-818-8508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16703 SE MCGILLIVRAY BLVD STE 175",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834301",
            "telephone_number": "360-818-8508"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "404 E Main St",
            "address_purpose": "LOCATION",
            "city": "Battle Ground",
            "state": "WA",
            "postal_code": "986048506",
            "country_code": "US",
            "telephone_number": "360-818-8508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NW EVERGREEN CHIROPRACTIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-23",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-604-8968",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.