Evergreen Washington Healthcare Seattle, L.L.C.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH1228 Issued in WA

Legal business name

EVERGREEN WASHINGTON HEALTHCARE SEATTLE, L.L.C.

Practice address

555 16TH Ave
Seattle, WA 98122-8122

Phone

(206) 324-8200

Fax

(206) 709-8457

NPI assigned

Sep 14, 2005

Organization subpart

Yes

Parent organization

EMPRES WASHINGTON HEALTHCARE, LLCAs reported in NPPES

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

Authorized official

Name

Brent Weil

Title

Ceo and Manager

Phone

(360) 892-6628

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Seattle Medical Post Acute Care Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Lynn Azen, M.D., M.P.H.

  • Internal Medicine Physician
  • Kent, WA
  • NPI 1073703294
  NPD (past)

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485734400000",
    "number": "1851386957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 NE 77TH AVE",
            "address_2": "SUITE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626736",
            "telephone_number": "360-892-6628",
            "fax_number": "360-882-5793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 16TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981228122",
            "telephone_number": "206-324-8200",
            "fax_number": "206-709-8457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN WASHINGTON HEALTHCARE SEATTLE, L.L.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EMPRES WASHINGTON HEALTHCARE, LLC",
        "enumeration_date": "2005-09-14",
        "last_updated": "2017-01-30",
        "status": "A",
        "authorized_official_last_name": "WEIL",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "CEO AND MANAGER",
        "authorized_official_telephone_number": "360-892-6628"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "NH1228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4112280",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seattle Medical Post Acute Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Evergreen Treatment Services Unit 3
• Evergreen Treatment Services Unit 4
• Evergreen Treatment Services Unit 6
• Evergreen Treatment Services Unit 7
• Evergreen Vision Corp.
• Mark Everhart
• Toby Anna Everhart, LMP
• Alyssa Everitt, RD, MSW, LSWAIC
• Evernorth Care Providers - Arizona PC
• Evershield Care LLC

• Skilled Nursing Facility in Seattle, WA
• Providers in Seattle, WA by specialty
• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; 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.