EVERGREEN EYE CENTER PLLC NPI 1821167479

NPI Information

  • NPI: 1821167479
  • Provider Name: EVERGREEN EYE CENTER, PLLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Doing Business As: EVERGREEN EYE SURGERY CENTER
  • CLIA Number: 50D0926546
  • 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 ambulatory surgical clinic center in Federal Way, WA. EVERGREEN EYE CENTER, PLLC NPI is 1821167479. The provider is registered as an organization entity type.
The provider Is Doing Business As Evergreen Eye Surgery Center.

The provider's business location address is:

34719 6TH AVE S
FEDERAL WAY, WA
ZIP 98003-714
Phone: (206) 212-2100
Fax: (206) 212-2174

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 50D0926546 - physician office with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Removal of cataract with insertion of prosthetic lens (HCPCS:66984)
  • Removal of recurring cataract in lens capsule using a laser (HCPCS:66821)
  • Laser repair to improve eye fluid flow (HCPCS:65855)
  • Complex removal of cataract with insertion of prosthetic lens (HCPCS:66982)
  • Removal of excessive skin and fat of upper eyelid (HCPCS:15823)
  • Repair of tendon of upper eyelid (HCPCS:67904)
  • Incision to improve eye fluid flow (HCPCS:65820)

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
1261QA1903XClinic/CenterAmbulatory SurgicalYes

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
1490003159OTHERWASHINGTONRAILROAD MEDICARE ASC NUM
27081250MEDICAIDWASHINGTON
3EV5682OTHERWASHINGTONREGENCE ASC NUMBER
4P06705OTHERWASHINGTONPCMB ASC NUMBER
5111881OTHERWASHINGTONL&I ASC NUMBER
6NBNOTHERWASHINGTONWA0527

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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