NPIMap

Organization Active NPI

Evergreen Eye Center, PLLC

  • Ambulatory Surgical Clinic/Center
  • Seattle, WA
National Provider Identifier
1861237364
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
EVERGREEN EYE CENTER, PLLC
Practice address
1455 NW Leary Way Ste 300
Seattle, WA 98107-5138
Phone
(206) 784-3550
Fax
(206) 342-6166
NPI assigned
Jun 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Authorized official

Name
Gary Whakuk Chung
Title
Manager
Phone
(206) 212-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

1455 NW Leary Way Ste 300
Seattle, WA 98107-5138

Mailing address

1101 Madison St Ste 300
Seattle, WA 98104-1306
Phone (206) 784-3550

Other names 1

  • Eye Associates Northwest Surgery Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Evergreen Eye Surgery C11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

1101 Madison St
Ste 300
Seattle, WA 98104

NPI Registry JSON

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1861237364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST STE 300",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041306",
            "telephone_number": "206-784-3550",
            "fax_number": "206-342-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 NW LEARY WAY STE 300",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981075138",
            "telephone_number": "206-784-3550",
            "fax_number": "206-342-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN EYE CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "WHAKUK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "206-212-2100"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Associates Northwest Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.