Individual provider Active NPI

Kathleen Joy Evermann, LICSW

  • Clinical Social Worker
  • Pullman, WA
National Provider Identifier
1952676751
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW 60147911 Issued in WA
Practice address
835 SE Bishop Blvd
Pullman, WA 99163-5512
Phone
(509) 432-3465
NPI assigned
Mar 13, 2012
Last updated
Aug 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LW 60147911 WA Primary

Addresses

Primary practice location

835 SE Bishop Blvd
Pullman, WA 99163-5512

Mailing address

835 SE Bishop Blvd
Pullman, WA 99163-5512
Phone (509) 432-3465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250918004691 ID Practitioner - Clinical Social Worker 0749784049 Reassigns benefits to 1 organization
I20250919003378 WA Practitioner - Clinical Social Worker 0749784049 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

840 SE Bishop Blvd
Suite 103
Pullman, WA 99163-5502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW 60147911WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District #1-a of Whitman County CurrentSince Sep 1, 2025 Accepting new patients
Public Hospital District #1-a of Whitman County Past Accepting new patients

Locations

2500 W A St
Ste 201
Moscow, ID 83843
Phone (208) 332-2828

1420 S Blaine St
Ste 5
Moscow, ID 83843
Phone (208) 882-2247

835 SE Bishop Blvd
Pullman, WA 99163
Phone (509) 332-2541

1205 SE Professional Mall Blvd
Ste 104
Pullman, WA 99163
Phone (509) 332-2605

840 SE Bishop Blvd
Ste 103
Pullman, WA 99163
Phone (509) 336-7609

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1952676751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 SE BISHOP BLVD",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635512",
            "telephone_number": "509-432-3465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 SE BISHOP BLVD",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635512",
            "telephone_number": "509-432-3465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERMANN",
        "first_name": "KATHLEEN",
        "middle_name": "JOY",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-13",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW 60147911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pullman, WA

Sources for this page

Verify at the official NPI Registry.