EVERGREEN FOOT & ANKLE SPECIALISTS PLLC NPI 1386956704

NPI Information

NPI: 1386956704
Provider Name: EVERGREEN FOOT & ANKLE SPECIALISTS PLLC
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

CLIA Number: 50D2048522

Address:
2415 SE 165TH AVE STE 104
VANCOUVER, WA
ZIP 98683
Phone: (360) 694-3668
Get Directions

EVERGREEN FOOT & ANKLE SPECIALISTS PLLC is a foot and ankle surgery podiatrist in Vancouver, WA. EVERGREEN FOOT & ANKLE SPECIALISTS PLLC NPI is 1386956704. The provider is registered as an organization entity type.

The provider's business location address is:

2415 SE 165TH AVE STE 104
VANCOUVER, WA
ZIP 98683-324
Phone: (360) 694-3668
Fax: (360) 882-3566

The provider's authorized official is Kurt W Davis .
The authorized official title is Manager and has the following contact phone number (360) 694-3668.

The CLIA number assigned to this NPI record is 50D2048522 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/14/2010 and was last updated on 9/14/2010.

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
1	332BC3200X	Durable Medical Equipment & Medical Supplies	Customized Equipment	PO000000682	WASHINGTON	No
2	213ES0103X	Podiatrist	Foot & Ankle Surgery	PO00000682	WASHINGTON	Yes

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: 4/28/2024

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