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EVERGREEN TREATMENT SERVICES NPI 1871729491


NPI Information

NPI: 1871729491
Provider Name: EVERGREEN TREATMENT SERVICES

Doing Business As: SOUTH SOUND CLINIC

Classification: Clinic/Center - 261QM2800X
Entity Type: Organization

Specialization: Methadone

Address:
6700 MARTIN WAY E STE 117
OLYMPIA, WA
ZIP 98516
Phone: (360) 413-6910
Get Directions

EVERGREEN TREATMENT SERVICES is a methadone clinic center in Olympia, WA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. EVERGREEN TREATMENT SERVICES NPI is 1871729491. The provider is registered as an organization entity type.
The provider Is Doing Business As South Sound Clinic.

The provider's business location address is:

6700 MARTIN WAY E STE 117
OLYMPIA, WA
ZIP 98516-586
Phone: (360) 413-6910
Fax: (360) 413-9026

The provider's authorized official is Margaret Carney .
The authorized official title is Executive Director and has the following contact phone number (206) 223-3644.

The enumeration date for this NPI number is 6/10/2009 and was last updated on 4/11/2017.


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
1261QM2800XClinic/CenterMethadone34111900WASHINGTONYes

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
11995927MEDICAIDWASHINGTON
28008203MEDICAIDWASHINGTON

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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