Evergreen Circuits LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

EVERGREEN CIRCUITS LLC

Practice address

14023 284TH Cir NE
Duvall, WA 98019-8176

Phone

(425) 382-8412

NPI assigned

Jun 27, 2019

Last updated

Jun 27, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jay Beavers

Title

Managing Memberr

Phone

(425) 382-8412

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561593600000",
    "number": "1700447968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1304",
            "city": "DUVALL",
            "state": "WA",
            "postal_code": "980191304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14023 284TH CIR NE",
            "city": "DUVALL",
            "state": "WA",
            "postal_code": "980198176",
            "telephone_number": "425-382-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN CIRCUITS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-27",
        "last_updated": "2019-06-27",
        "status": "A",
        "authorized_official_last_name": "BEAVERS",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "MANAGING MEMBERR",
        "authorized_official_telephone_number": "425-382-8412"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Duvall Advanced Family Eyecare, PS
• Duvall Hills Adult Family Home LLC
• Kelsey Maureen Ellingson, MS, NCC, LHMC
• Emma Etemadi, DDS, PS (Duvall Family Dental)
• Emma Kate Etemadi, DDS, PS
• Joshua Cal Evergreen, LMHCA
• David S Farrell, D.O.
• Nancy Ferara, RN
• Moriah Flagler
• Kayla Marie Fox

• Durable Medical Equipment & Medical Supplies in Duvall, WA
• Providers in Duvall, WA by specialty
• Durable Medical Equipment & Medical Supplies in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.