Organization Active NPI

Evergreen Park Afh

  • Adult Care Home Facility
  • Bellevue, WA
National Provider Identifier
1912794819
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
EVERGREEN PARK AFH
Practice address
17126 SE 29TH PL
Bellevue, WA 98008-5600
Phone
(206) 660-1273
NPI assigned
Apr 23, 2025
Last updated
Apr 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Authorized official

Name
Adrian Balasa
Title
Office Administrator
Phone
(425) 753-2416

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X NU Primary

Addresses

Primary practice location

17126 SE 29TH PL
Bellevue, WA 98008-5600

Mailing address

17126 SE 29TH PL
Bellevue, WA 98008-5600
Phone (206) 660-1273

Other practice location 1

142 S 295th Pl
Federal Way, WA 98003-3659
Phone (253) 839-9438

Other practice location 2

32020 11th Ave SW
Federal Way, WA 98023-5548
Phone (253) 344-1139

Other practice location 3

7520 E Green Lake Dr N
Seattle, WA 98103-4912
Phone (206) 985-2048

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1745366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745366400000",
    "number": "1912794819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17126 SE 29TH PL",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980085600",
            "telephone_number": "206-660-1273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17126 SE 29TH PL",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980085600",
            "telephone_number": "206-660-1273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "142 S 295th Pl",
            "address_purpose": "LOCATION",
            "city": "Federal Way",
            "state": "WA",
            "postal_code": "980033659",
            "country_code": "US",
            "telephone_number": "253-839-9438",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "32020 11th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Federal Way",
            "state": "WA",
            "postal_code": "980235548",
            "country_code": "US",
            "telephone_number": "253-344-1139",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7520 E Green Lake Dr N",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981034912",
            "country_code": "US",
            "telephone_number": "206-985-2048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EVERGREEN PARK AFH",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-23",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A",
        "authorized_official_last_name": "BALASA",
        "authorized_official_first_name": "ADRIAN",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "425-753-2416"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; 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.