NPIMap

Organization Active NPI

The Evergreen Clinic

  • Psychiatry Physician
  • Kirkland, WA
National Provider Identifier
1447314539
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
601889816 Issued in WA
Legal business name
THE EVERGREEN CLINIC
Practice address
12025 115TH Ave NE
#200
Kirkland, WA 98034
Phone
(425) 821-1810
Fax
(425) 823-1231
NPI assigned
Dec 21, 2006
Last updated
Apr 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

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

Authorized official

Name
Anne R. Lucas, LMHCNPI 1801948468
Title
Owner
Phone
(425) 821-1810

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
Psychiatry Physician 2084P0800X 601889816 WA Primary

Addresses

Primary practice location

12025 115TH Ave NE
#200
Kirkland, WA 98034

Mailing address

12025 115TH Ave NE
#200
Kirkland, WA 98034
Phone (425) 821-1810

National Provider Directory

National Provider Directory

Locations

10126 NE 132nd St
Kirkland, WA 98034
Phone (425) 821-1810

10126 NE 132nd St
Ste D
Kirkland, WA 98034
Phone (425) 821-1810

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430092800000",
    "number": "1447314539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12025 115TH AVE NE",
            "address_2": "#200",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "98034",
            "telephone_number": "425-821-1810",
            "fax_number": "425-823-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12025 115TH AVE NE",
            "address_2": "#200",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "98034",
            "telephone_number": "425-821-1810",
            "fax_number": "425-823-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EVERGREEN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2015-04-27",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-821-1810",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "601889816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 27, 2015; 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.