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EVERGREEN EYE CENTER PLLC NPI 1881763373


NPI Information

NPI: 1881763373
Provider Name: EVERGREEN EYE CENTER, PLLC

Doing Business As: EVERGREEN EYE CENTER

Classification: Ophthalmology - 207W00000X
Entity Type: Organization
Address:
2820 GRIFFIN AVE STE 101
ENUMCLAW, WA
ZIP 98022
Phone: (360) 802-4549
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EVERGREEN EYE CENTER, PLLC is an ophthalmology in Enumclaw, WA. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. EVERGREEN EYE CENTER, PLLC NPI is 1881763373. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Evergreen Eye Center.

The provider's business location address is:

2820 GRIFFIN AVE STE 101
ENUMCLAW, WA
ZIP 98022-373
Phone: (360) 802-4549
Fax: (360) 825-8354

The provider's authorized official is Rosa Angelica Campos .
The authorized official title is Credentialing Manager and has the following contact phone number (206) 215-2004.

The enumeration date for this NPI number is 11/7/2006 and was last updated on 1/12/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152W00000XOptometristNo
2207W00000XOphthalmologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1891451OTHERWASHINGTONCRIME VICS ENUMCLAW EEC
2WA0527OTHERWASHINGTONNBN
30870427OTHERWASHINGTONAETNA
47080781MEDICAIDWASHINGTON
5EV8144OTHERWASHINGTONKCM

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.