NPIMap

Organization Active NPI

Evergreen Pediatrics PLLC

  • Primary Care Clinic/Center
  • Kirkland, WA
National Provider Identifier
1184885675
Registry record updated Feb 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
EVERGREEN PEDIATRICS PLLC
Practice address
433 State St S Ste 1
Kirkland, WA 98033-6615
Phone
(425) 828-3626
Fax
(425) 828-3628
NPI assigned
Jun 18, 2008
Organization subpart
Yes
Parent organization
BASMA RAEESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 20, 2013

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

Authorized official

Name
Basma Raees, M.D.NPI 1205045739
Title
Owner
Phone
(425) 828-3626

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
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

433 State St S Ste 1
Kirkland, WA 98033-6615

Mailing address

433 State St S
Suite 6
Kirkland, WA 98033-6615
Phone (425) 828-3626

Other names 1

  • Basma Raees Other name

National Provider Directory

National Provider Directory

Locations

433 State St S Ste 6
Ste 6
Kirkland, WA 98033
Phone (425) 284-6884

Practitioners & affiliated clinicians

Practitioners 6

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": "1213747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361318400000",
    "number": "1184885675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 STATE ST S",
            "address_2": "SUITE 6",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336615",
            "telephone_number": "425-828-3626",
            "fax_number": "425-828-3628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 STATE ST S STE 1",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336615",
            "telephone_number": "425-828-3626",
            "fax_number": "425-828-3628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN PEDIATRICS PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BASMA RAEES",
        "enumeration_date": "2008-06-18",
        "last_updated": "2013-02-20",
        "status": "A",
        "authorized_official_last_name": "RAEES",
        "authorized_official_first_name": "BASMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-828-3626",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Basma Raees",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; 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.