NPIMap

Organization Active NPI

Public Hospital District No. 2

Doing business as Evergreen Hospital Medical Center

  • General Acute Care Hospital
  • Kirkland, WA
National Provider Identifier
1548463474
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
H-164 Issued in WA
Legal business name
PUBLIC HOSPITAL DISTRICT NO. 2
Doing business as
Evergreen Hospital Medical Center
Practice address
12040 NE 128TH Street
Kirkland, WA 98034-3013
Phone
(509) 344-9924
Fax
(509) 456-8811
NPI assigned
Jun 7, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kellie Spurgeon
Title
Credentialing Coordinator
Phone
(509) 344-9924

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X H-164 WA Primary

Addresses

Primary practice location

12040 NE 128TH Street
Kirkland, WA 98034-3013

Mailing address

819 W 7TH Ave
Spokane, WA 99204-2808
Phone (509) 344-9924

Other names 1

  • Evergreen Hospital Medical Center Doing business as

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
50D0686436Evergreen Hospital Medical Center Lab12040 NE 128TH St Ms-44, Kirkland, WA 98034AccreditationApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Public Hosp District No 225 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548463474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 W 7TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042808",
            "telephone_number": "509-344-9924",
            "fax_number": "509-456-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12040 NE 128TH STREET",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343013",
            "telephone_number": "509-344-9924",
            "fax_number": "509-456-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HOSPITAL DISTRICT NO. 2",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SPURGEON",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "509-344-9924"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "WA",
            "license": "H-164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Hospital Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 2020; 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.