Evergreen Myohabits LLC

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

Legal business name

EVERGREEN MYOHABITS LLC

Practice address

701 NE 136TH Ave Ste 200
Vancouver, WA 98684-6937

Phone

(360) 448-1830

NPI assigned

May 22, 2023

Organization subpart

No

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

Authorized official

Name

Yelena Likhatskiy, DENTAL HYGIENIST

Title

Myofunctional Therapist

Phone

(360) 448-1830

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685059200000",
    "number": "1457043119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 NE 136TH AVE STE 200",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986846937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 NE 136TH AVE STE 200",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986846937",
            "telephone_number": "360-448-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN MYOHABITS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A",
        "authorized_official_last_name": "LIKHATSKIY",
        "authorized_official_first_name": "YELENA",
        "authorized_official_title_or_position": "MYOFUNCTIONAL THERAPIST",
        "authorized_official_telephone_number": "360-448-1830",
        "authorized_official_credential": "DENTAL HYGIENIST"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evergreen Dental
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• Evergreen Foot & Ankle Specialists PLLC
• Evergreen Medical Transportation LLC
• Evergreen Pediatric Clinic PS
• Evergreen Prosthetics and Orthotics, LLC
• Evergreen Prosthetics and Orthotics, LLC
• Evergreen Quality Home
• Evergreen School District Vancouver 114

• Dental Hygienist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Dental Hygienist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.