EVERGREEN EYE CENTER PLLC NPI 1700959293

NPI Information

NPI: 1700959293
Provider Name: EVERGREEN EYE CENTER, PLLC
Classification: Ophthalmology - 207W00000X
Entity Type: Organization
Former Legal Business Name: EVERGREEN EYE CENTER OF FEDERAL WAY INC., P.S.
Address: 34719 6TH AVE S
FEDERAL WAY, WA
ZIP 98003
Phone: (206) 212-2100

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NPI Details

EVERGREEN EYE CENTER, PLLC is an ophthalmology in Federal Way, 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 1700959293. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Evergreen Eye Center Of Federal Way Inc., P.s..

The provider's business location address is:

34719 6TH AVE S
FEDERAL WAY, WA
ZIP 98003-714
Phone: (206) 212-2100
Fax: (206) 212-2194

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 11/15/2006 and was last updated on 1/4/2024.

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
1	152W00000X	Optometrist				No
2	207W00000X	Ophthalmology				Yes

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
1	0870427	OTHER	WASHINGTON	AETNA NUMBER
2	WA0527	OTHER	WASHINGTON	EEC NBN NUMBER
3	891451	OTHER	WASHINGTON	CRIME VICTIMS EEC NUMBER
4	EV8144	OTHER	WASHINGTON	EEC KCM GROUP NUMBER
5	59460	OTHER	WASHINGTON	EEC L&I NUMBER
6	7080781	MEDICAID	WASHINGTON
7	2017242	MEDICAID	WASHINGTON
8	P04799	OTHER	WASHINGTON	PCMB GROUP EEC NUMBER

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: 11/21/2025

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