NPIMap

Organization Active NPI

Evergreen Healthcare

  • General Acute Care Hospital
  • Kirkland, WA
National Provider Identifier
1508258765
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
00020647 Issued in WA
Legal business name
EVERGREEN HEALTHCARE
Practice address
12040 NE 128TH St
Kirkland, WA 98034-3013
Phone
(425) 899-2783
Fax
(425) 899-2784
NPI assigned
Feb 25, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Authorized official

Name
Mr. Don Briggs, RPH
Title
Pharmacy Director
Phone
(425) 899-2783

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 00020647 WA Primary

Addresses

Primary practice location

12040 NE 128TH St
Kirkland, WA 98034-3013

Mailing address

12040 NE 128TH St
Tan 415
Kirkland, WA 98034-3098
Phone (425) 899-2783

National Provider Directory

National Provider Directory
Tax ID family
Evergreen Healthcare2 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

12040 NE 128th St
#415
Kirkland, WA 98034
Phone (425) 899-2783

Practitioners & affiliated clinicians

Practitioners 4

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": "1424822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424822400000",
    "number": "1508258765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12040 NE 128TH ST",
            "address_2": "TAN 415",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343098",
            "telephone_number": "425-899-2783",
            "fax_number": "425-899-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12040 NE 128TH ST",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343013",
            "telephone_number": "425-899-2783",
            "fax_number": "425-899-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-25",
        "last_updated": "2015-02-25",
        "status": "A",
        "authorized_official_last_name": "BRIGGS",
        "authorized_official_first_name": "DON",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "425-899-2783",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "WA",
            "license": "00020647",
            "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 Feb 25, 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.