NPIMap

Organization Active NPI

Evergreen Naturopathic

  • Naturopath
  • Spokane, WA
National Provider Identifier
1396888541
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
NT00001028 Issued in WA
Legal business name
EVERGREEN NATUROPATHIC
Practice address
1801 W. Broadway Ave
Suite 2
Spokane, WA 99201
Phone
(509) 755-5100
Fax
(509) 747-6646
NPI assigned
Feb 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Authorized official

Name
Dr. Alycia Renee Policani, NDNPI 1457439762
Title
President
Phone
(509) 755-5100

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
NaturopathGroup: 193400000X SINGLE SPECIALTY GROUP 175F00000X NT00001028 WA Primary

Addresses

Primary practice location

1801 W. Broadway Ave
Suite 2
Spokane, WA 99201

Mailing address

1801 W. Broadway Ave
Suite 2
Spokane, WA 99201
Phone (509) 755-5100

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2254995Evergreen Naturopathic1801 W Broadway Ave Ste 2, Spokane, WA 99201Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Evergreen Naturopathic Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1801 W Broadway Ave
Ste 2
Spokane, WA 99201
Phone (509) 755-5100

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

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": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648166400000",
    "number": "1396888541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W. BROADWAY AVE",
            "address_2": "SUITE 2",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99201",
            "telephone_number": "509-755-5100",
            "fax_number": "509-747-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W. BROADWAY AVE",
            "address_2": "SUITE 2",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99201",
            "telephone_number": "509-755-5100",
            "fax_number": "509-747-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN NATUROPATHIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A",
        "authorized_official_last_name": "POLICANI",
        "authorized_official_first_name": "ALYCIA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-755-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Naturopath",
            "state": "WA",
            "license": "NT00001028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.