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EVERGREEN EYE CENTER PLLC NPI 1538238043


NPI Information

NPI: 1538238043
Provider Name: EVERGREEN EYE CENTER, PLLC

Doing Business As: EVERGREEN EYE CENTER

Classification: Ophthalmology - 207W00000X
Entity Type: Organization

CLIA Number: 50D2078287

Address:
15153 5TH AVE SW
BURIEN, WA
ZIP 98166
Phone: (800) 340-3595
Get Directions

EVERGREEN EYE CENTER, PLLC is an ophthalmology in Burien, 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 1538238043. 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:

15153 5TH AVE SW
BURIEN, WA
ZIP 98166-072
Phone: (800) 340-3595
Fax: (855) 929-1515

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 CLIA number assigned to this NPI record is 50D2078287 - physician office with a certificate type of Certificate of Waiver.

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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
159460OTHERWASHINGTONL&I
27080781MEDICAIDWASHINGTON
3P04799OTHERWASHINGTONPCMB
42017242MEDICAIDWASHINGTON
5EV8144OTHERWASHINGTONKCM
60870427OTHERWASHINGTONAETNA
7891451OTHERWASHINGTONCRIME VICTIMS
8WA0527OTHERWASHINGTONNBN

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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