EVERGREEN PEDIATRICS PLLC (NPI# 1184885675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184885675 |
| Entity Type | Organization |
| Organization Name | EVERGREEN PEDIATRICS PLLC |
| Other Organization Name | BASMA RAEES |
| Practice Address |
433 State St S Ste 1 Kirkland WA 98033-6615 |
| Mailing Address |
433 State St S Suite 6 Kirkland WA 98033-6615 |
| Practice Telephone | 4258283626 |
| Practice Fax Number | 4258283628 |
| Mailing Telephone | 4258283626 |
| Mailing Fax Number | 4258283628 |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2013-02-20 |
| Authorized Official Name | BASMA RAEES (OWNER) |
| Authorized Official Telephone | 4258283626 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | BASMA RAEES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Basma Raees | Other Name - Individual/Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | EVERGREEN PEDIATRICS PLLC | 12911 120th Ave Ne Ste B # 10, Kirkland, WA 98034-3027 |
| Street Address |
433 STATE ST S STE 1 |
| City | KIRKLAND |
| State | WA |
| Zip Code | 98033-6615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558521237 | Diana Tattoni | Clinic/Center | 433 State St S Ste 1, Kirkland, WA 98033-6615 | 2008-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710584826 | Raquel Maria Reyes | Interpreter | 11205 Ne 62nd St., Kirkland, WA 98033 | 2020-10-02 |
| 1588146468 | Lake Washington Family Chiropractic, Pllc | Chiropractor | 816 6th Street South, 816 6th Street South, Kirkland, WA 98033 | 2018-09-06 |
| 1316463557 | Tony Jia Ly | Pharmacist | 7224 120th Ave Ne, Kirkland, WA 98033 | 2017-08-18 |
| 1003356403 | Eden Home Health of King County, LLC | Home Health | 733 7th Avenue, Suite 110, Kirkland, WA 98033 | 2017-03-03 |
| 1184170763 | Kirkland Family Dentistry | Dentist | 1715 Market St #104, Kirkland, WA 98033 | 2016-09-01 |
| 1144688565 | Kamala Psychology and Yoga LLC | Psychologist | 603 4th Ave Ste 101, Kirkland, WA 98033 | 2016-01-30 |
| 1245695352 | Ron Massey | Massage Therapist | 11406 Ne 112th St, Kirkland, WA 98033 | 2015-12-17 |
| 1194106039 | John Pham | Internal Medicine | 9426 116th Ave Ne, Kirkland, WA 98033 | 2015-06-16 |
| 1992199970 | Garrison Patrick Wier | Ophthalmology | 625 4th Ave Ste 301, Kirkland, WA 98033 | 2015-03-26 |
| 1871993113 | Abigail Trajtenberg Loomis | Behavioral Analyst | 1003 7th Avenue, Kirkland, WA 98033 | 2014-08-22 |
| Find all providers in zip 98033 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750896270 | Katherine Martin, Nd Pllc | Clinic/Center | 13128 Totem Lake Blvd Ne Ste 104, Kirkland, WA 98034-2953 | 2017-12-06 |
| 1558521237 | Diana Tattoni | Clinic/Center | 433 State St S Ste 1, Kirkland, WA 98033-6615 | 2008-06-16 |
| 1164876322 | Evergreenhealth | Clinic/Center | 11521 Ne 128th St, Suite 100, Kirkland, WA 98034-4317 | 2016-04-14 |
| 1699166439 | Vera Whole Health Wa PC | Clinic/Center | 13123 121st Way Ne, Suite D, Kirkland, WA 98034 | 2015-02-16 |
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| 1992315808 | Vera Whole Health Wa, PC | Clinic/Center | 6700 Fort Dent Way Ste 100, Tukwila, WA 98188-2500 | 2020-08-05 |
| 1063037034 | Pioneer Family Medicine, Pllc | Clinic/Center | 20 E J St Ste 2b, Deer Park, WA 99006-8500 | 2020-06-15 |
| 1922622158 | Vera Whole Health Wa, PC | Clinic/Center | 16009 E Indiana Ave, Spokane Valley, WA 99216 | 2020-06-03 |
| 1578183729 | Family Care Network Pllc | Clinic/Center | 3548 Meridian St, Suite #101-b, Bellingham, WA 98225 | 2020-04-17 |
| 1548800451 | Vera Whole Health Wa PC | Clinic/Center | 1601 N Division St, Spokane, WA 99207-2427 | 2020-01-08 |
| 1821634312 | Columbia Basin Mobile Medicine LLC | Clinic/Center | 1357 Platinum Pl, West Richland, WA 99353-5108 | 2019-11-20 |
| 1063056497 | A Community Wellness Clinic LLC | Clinic/Center | 2405 E 17th Ave Ste 113, Spokane, WA 99223-5122 | 2019-10-29 |
| 1013550987 | Rejuventa Medical Corp. | Clinic/Center | 107 North Tower Ave Suite 17, Centralia, WA 98531-4253 | 2019-10-23 |
| 1023668407 | Vera Whole Health Wa, PC | Clinic/Center | 4933 Evergreen Way, Everett, WA 98203-2828 | 2019-09-17 |
| 1679042501 | Family and Wellness Medicine | Clinic/Center | 34004 16th Ave S Ste 100, Federal Way, WA 98003-8905 | 2018-11-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.