NPIMap

Organization Active NPI

Evergreen Park Professionals

  • Clinical Psychologist
  • Everett, WA
National Provider Identifier
1932224672
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
EVERGREEN PARK PROFESSIONALS
Practice address
127 E Intercity Ave
Suite a
Everett, WA 98208-2732
Phone
(425) 347-7275
Fax
(425) 355-0626
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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

Authorized official

Name
Cindy Williams
Title
Receptionist
Phone
(425) 347-7275

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

127 E Intercity Ave
Suite a
Everett, WA 98208-2732

Mailing address

127 E Intercity Ave
Suite a
Everett, WA 98208-2732
Phone (425) 347-7275

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221696000000",
    "number": "1932224672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 E INTERCITY AVE",
            "address_2": "SUITE A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982082732",
            "telephone_number": "425-347-7275",
            "fax_number": "425-355-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 E INTERCITY AVE",
            "address_2": "SUITE A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982082732",
            "telephone_number": "425-347-7275",
            "fax_number": "425-355-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN PARK PROFESSIONALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2008-09-18",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "RECEPTIONIST",
        "authorized_official_telephone_number": "425-347-7275"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; 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.