NPIMap

Organization Active NPI

King County Public Hospital District No. 2

Doing business as EvergreenHealth Medical Group

  • Neurological Surgery Physician
  • Port Angeles, WA
National Provider Identifier
1548740210
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
KING COUNTY PUBLIC HOSPITAL DISTRICT NO. 2
Doing business as
EvergreenHealth Medical Group
Practice address
939 Caroline St
Port Angeles, WA 98362
Phone
(425) 899-5590
Fax
(425) 899-4859
NPI assigned
Aug 21, 2018
Last updated
Aug 21, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
KING COUNTY PUBLIC HOSPITAL DISTRICT NO. 2As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

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

Authorized official

Name
Tina Christine Mycroft
Title
Sr. VP-Chief Financial Officer
Phone
(425) 899-2606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X Primary

Addresses

Primary practice location

939 Caroline St
Port Angeles, WA 98362

Mailing address

PO Box 34036
Seattle, WA 98124-1036
Phone (425) 899-3266

Other names 1

  • EvergreenHealth Medical Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Evergreen Hosp Medical25 organizations share this tax ID, including this one
Part of
Evergreen Hosp Medical

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": "1534809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534809600000",
    "number": "1548740210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34036",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241036",
            "telephone_number": "425-899-3266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 CAROLINE ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "98362",
            "telephone_number": "425-899-5590",
            "fax_number": "425-899-4859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING COUNTY PUBLIC HOSPITAL DISTRICT NO. 2",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KING COUNTY PUBLIC HOSPITAL DISTRICT NO. 2",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-08-21",
        "status": "A",
        "authorized_official_last_name": "MYCROFT",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "CHRISTINE",
        "authorized_official_title_or_position": "SR. VP-CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "425-899-2606"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EvergreenHealth Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Angeles, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; 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.