EVERGREEN RADIA LLC NPI 1922095694

NPI Information

NPI: 1922095694
Provider Name: EVERGREEN RADIA LLC
Classification: Radiology - 2085R0202X
Specialization: Diagnostic Radiology
Entity Type: Organization
Doing Business As: EVERGREEN RADIA
CLIA Number: 50D1099043
Address: 11521 NE 128TH ST
SUITE 200
KIRKLAND, WA
ZIP 98034
Phone: (425) 952-6100

Map and Directions

Get Directions

NPI Details

EVERGREEN RADIA LLC is a diagnostic radiology radiology in Kirkland, WA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. EVERGREEN RADIA LLC NPI is 1922095694. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Evergreen Radia.

The provider's business location address is:

11521 NE 128TH ST
SUITE 200
KIRKLAND, WA
ZIP 98034-317
Phone: (425) 952-6100
Fax: (425) 952-6150

The provider's authorized official is Lloyd Stambaugh .
The authorized official title is President and has the following contact phone number (425) 563-1500.

The CLIA number assigned to this NPI record is 50D1099043 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/28/2005 and was last updated on 9/12/2018.

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	2085R0202X	Radiology	Diagnostic Radiology	602317167	WASHINGTON	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	175238	OTHER	WASHINGTON	GROUP LABOR & INDUSTRIES
2	7118227	MEDICAID	WASHINGTON
3	8933574	OTHER	WASHINGTON	GROUP CRIME VICTIMS

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: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI

Next NPI