NPIMap

Organization Active NPI

Public Hospital District No 2 of King County

Doing business as Evergreen Professional Center Pharmacy

  • Community/Retail Pharmacy
  • Kirkland, WA
National Provider Identifier
1598832412
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHARCF00004833 Issued in WA
Legal business name
PUBLIC HOSPITAL DISTRICT NO 2 OF KING COUNTY
Doing business as
Evergreen Professional Center Pharmacy
Practice address
12303 NE 130TH LN
Ste 210
Kirkland, WA 98034-3099
Phone
(425) 899-2790
Fax
(425) 899-2795
NPI assigned
Nov 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2016

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

Authorized official

Name
Donald Briggs, RPH
Title
Director
Phone
(425) 899-2794

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHARCF00004833 WA Primary

Addresses

Primary practice location

12303 NE 130TH LN
Ste 210
Kirkland, WA 98034-3099

Mailing address

12303 NE 130TH LN
Ste 210
Kirkland, WA 98034-3099
Phone (425) 899-2790

Other identifiers 2

IdentifierTypeStateIssuer
2109598OtherPK
6013734MedicaidWA

Other names 1

  • EVERGREEN PROFESSIONAL CENTER PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ehmc Bothell Sr HLTH CT25 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

Locations

12303 NE 130th Ln
Ste 210
Kirkland, WA 98034
Phone (425) 899-2790

Practitioners & affiliated clinicians

Practitioners 5

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": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482192000000",
    "number": "1598832412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12303 NE 130TH LN",
            "address_2": "STE 210",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343099",
            "telephone_number": "425-899-2790",
            "fax_number": "425-899-2795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 NE 130TH LN",
            "address_2": "STE 210",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343099",
            "telephone_number": "425-899-2790",
            "fax_number": "425-899-2795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HOSPITAL DISTRICT NO 2 OF KING COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2016-12-20",
        "status": "A",
        "authorized_official_last_name": "BRIGGS",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "425-899-2794",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "PHARCF00004833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2109598",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6013734",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EVERGREEN PROFESSIONAL CENTER PHARMACY",
            "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 Dec 20, 2016; 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.