NPIMap

Organization Active NPI

Evergreen Anesthesia Associates, LLC

  • Certified Registered Nurse Anesthetist
  • Sunnyside, WA
National Provider Identifier
1225575996
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP60306426 Issued in WA
Legal business name
EVERGREEN ANESTHESIA ASSOCIATES, LLC
Practice address
1016 Tacoma Ave
Sunnyside, WA 98944-2263
Phone
(509) 823-6682
NPI assigned
Jan 19, 2017
Last updated
Oct 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Authorized official

Name
Aaron EastmanNPI 1215351713
Title
Managing Partner
Phone
(480) 262-1862

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
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X AP60306426 WA Primary

Addresses

Primary practice location

1016 Tacoma Ave
Sunnyside, WA 98944-2263

Mailing address

3800 S Highlands Blvd
West Richland, WA 99353-6039
Phone (480) 262-1862

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171120002054 WA Part B Supplier - Clinic/Group Practice 7113284530 Receives reassigned benefits from 42 practitioners
Practice locations: Sunnyside, WA; Toppenish, WA; Yakima, WA

National Provider Directory

National Provider Directory

Locations

111 S 11th Ave
Ste 220
Yakima, WA 98902
Phone (509) 352-8810

Practitioners & affiliated clinicians

Practitioners 42

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1225575996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 S HIGHLANDS BLVD",
            "city": "WEST RICHLAND",
            "state": "WA",
            "postal_code": "993536039",
            "telephone_number": "480-262-1862",
            "fax_number": "509-357-8859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 TACOMA AVE",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442263",
            "telephone_number": "509-823-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN ANESTHESIA ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-19",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "EASTMAN",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "480-262-1862"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP60306426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyside, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.