Evergreen Nephrology Associates PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD00028956 Issued in WA

Legal business name

EVERGREEN NEPHROLOGY ASSOCIATES PLLC

Practice address

1708 Yakima Ave
Suite 107
Tacoma, WA 98405-5307

Phone

(253) 272-5881

Fax

(253) 383-0161

NPI assigned

May 20, 2006

Last updated

Aug 22, 2020By 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

Dr. Thomas Jacob Martin, MD

Title

Owner

Phone

(253) 272-5881

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Neil R Hannigan, MD

  • Nephrology Physician
  • Tacoma, WA
  • NPI 1508893090
  NPD (past)

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942254362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 YAKIMA AVE",
            "address_2": "SUITE 107",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055307",
            "telephone_number": "253-272-5881",
            "fax_number": "253-383-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 YAKIMA AVE",
            "address_2": "SUITE 107",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055307",
            "telephone_number": "253-272-5881",
            "fax_number": "253-383-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN NEPHROLOGY ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-272-5881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD00028956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7089881",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evergreen at Tacoma, L.L.C. (Alaska Gardens Health and Rehabilitation Center)
• Evergreen Eye Center, PLLC
• Evergreen Eye Center, PLLC (Evergreen Eye Center)
• Evergreen Medical Panel
• Evergreen Mobility
• Evergreen Oral Surgery
• Evergreen Spine and Posture Correction Center, LLC (Evergreen Spinal Health Center)
• Evergrowing Therapy PLLC
• Olivia Everitt, RD
• Everlast Family Dental Clinic

• Specialist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.