EVERGREEN TREATMENT SERVICES (NPI# 1417405333) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417405333 |
| Entity Type | Organization |
| Organization Name | EVERGREEN TREATMENT SERVICES |
| Practice Address |
1412 Sw 43rd St Suite 140 Renton WA 98057-4803 |
| Mailing Address |
1700 Airport Way S Seattle WA 98134-1618 |
| Practice Telephone | 4252640750 |
| Practice Fax Number | 4252640799 |
| Mailing Telephone | 2062233644 |
| Mailing Fax Number | 2062231482 |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2017-04-11 |
| Authorized Official Name | MARGARET CARNEY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2062233644 |
| Is Organization Subpart | Y |
| Parent Organization Name | EVERGREEN TREATMENT SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
17 0163 00 | WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8008203 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871729491 | Evergreen Treatment Services | Clinic/Center | 6700 Martin Way E Ste 117, Olympia, WA 98516-5586 | 2009-06-10 |
| 1851547244 | Evergreen Treatment Services | Clinic/Center | 1700 Airport Way S, Seattle, WA 98134-1618 | 2008-08-18 |
| 1508911777 | Evergreen Treatment Services | Clinic/Center | 1700 Airport Way S, Seattle, WA 98134-1618 | 2007-01-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | EVERGREEN TREATMENT SERVICES | 1700 Airport Way S, Seattle, WA 98134-1618 |
| Washington State Corporations | EVERGREEN TREATMENT SERVICES | 1700 Airport Way S, Seattle, WA 98134-1618 |
| Street Address |
1412 SW 43RD ST SUITE 140 |
| City | RENTON |
| State | WA |
| Zip Code | 98057-4803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487654331 | N W Eye Surgeons P C | Ophthalmology | 1412 Sw 43rd St, Suite 310, Renton, WA 98057-4803 | 2005-07-21 |
| 1568085454 | Jacqueline R. Buckley, LLC | Podiatrist | 1412 Sw 43rd St, Renton, WA 98057-4803 | 2020-05-26 |
| 1184191603 | Pacific Retina Center Pllc | Ophthalmology | 1412 Sw 43rd St, Renton, WA 98057-4803 | 2018-11-01 |
| 1336690684 | Geoffrey Natividad | Pharmacist | 1412 Sw 43rd St, 120, Renton, WA 98057-4803 | 2016-10-21 |
| 1386195048 | Reddi Enterprises Inc | Pharmacy | 1412 Sw 43rd St, 120, Renton, WA 98057-4803 | 2016-10-18 |
| 1396192803 | Concerto Medical Group of Washington, PC | General Practice | 1412 Sw 43rd St, Suite 315, Renton, WA 98057-4803 | 2016-05-16 |
| 1225421688 | Associated Valley Counseling, LLC | Counselor | 1412 Sw 43rd St, Suite 111, Renton, WA 98057-4803 | 2015-03-10 |
| 1649660853 | Lauren Rainbow | Social Worker | 1412 Sw 43rd St, Renton, WA 98057-4803 | 2015-01-26 |
| 1336539733 | Washington Center for Pain Management LLC | Anesthesiology | 1412 Sw 43rd St, Suite 110, Renton, WA 98057-4803 | 2015-01-23 |
| 1083022537 | Timothy Stewart | Counselor | 1412 Sw 43rd St, Suite 111, Renton, WA 98057-4803 | 2014-07-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043856628 | Megan Ramaiya | Student in an Organized Health Care Education/Training Program | King Count Sexual Assault & Resource Center, 200 Mill Ave S # 10, Renton, WA 98057 | 2019-11-19 |
| 1063076255 | Breanne Michele Smiley | Specialist/Technologist | 737 Logan Ave N, Renton, WA 98057 | 2019-04-24 |
| 1093215063 | Laura Lewis | Physical Medicine & Rehabilitation | 1000 Oakesdale Ave Sw Ste 100, Renton, WA 98057 | 2018-02-16 |
| 1437676004 | Ralph William Papke Jr. | Counselor | Kaiser Permanente of Wa, 1200 Sw 27th St, Renton, WA 98057 | 2017-08-24 |
| 1487106456 | Serengeti Care Partners LLC | Community/Behavioral Health | 707 S- Grady Way, Suite 6008, Renton, WA 98057 | 2016-10-26 |
| 1548716152 | Phandinh Ngoc Nguyen | Naturopath | 330 Sw 43rd St,suite L, Renton, WA 98057 | 2016-09-01 |
| 1275905721 | Todd R Glass | Chiropractor | 1024 N 10th Pl #2306, Renton, WA 98057 | 2015-10-23 |
| 1134595341 | Have A Heart | Case Management | 151 Taylor Ave Nw, Renton, WA 98057 | 2015-08-12 |
| 1780087171 | Brianne N Lefferts | Physical Therapist | 300 Sw 7th Street, Renton, WA 98057 | 2014-09-30 |
| 1588089460 | Sound Association Western Washington LLC | Audiologist | 108 Factory Ave. N., Ste 2b, Renton, WA 98057 | 2014-02-28 |
| Find all providers in zip 98057 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740755354 | Wchs, Inc. | Clinic/Center | 516 East 1st Street, Aberdeen, WA 98520 | 2018-10-10 |
| 1871729491 | Evergreen Treatment Services | Clinic/Center | 6700 Martin Way E Ste 117, Olympia, WA 98516-5586 | 2009-06-10 |
| 1215074539 | Wchs Vancouver Treatment Solutions | Clinic/Center | 2009 Ne 117th St, Suite 101, Vancouver, WA 98686-4022 | 2007-01-30 |
| 1558416685 | Evergreen Treatment Services Unit 4 | Clinic/Center | 1700 Airport Way S, Seattle, WA 98134-1618 | 2007-01-25 |
| 1548606171 | Therapeutic Health Services | Clinic/Center | 16715 Aurora Ave N Ste 102, Shoreline, WA 98133-5310 | 2013-05-22 |
| 1346497807 | Therapeutic Health Services | Clinic/Center | 1116 Summit Ave, Seattle, WA 98101-2831 | 2008-08-26 |
| 1851547244 | Evergreen Treatment Services | Clinic/Center | 1700 Airport Way S, Seattle, WA 98134-1618 | 2008-08-18 |
| 1588871693 | Comprehensive Healthcare | Clinic/Center | 402 S 4th Ave, Yakima, WA 98902 | 2007-05-17 |
| 1770638983 | Evergreen Treatment Services Unit 5 | Clinic/Center | 6700 Martin Way E, Olympia, WA 98516-6502 | 2007-01-25 |
| 1508911777 | Evergreen Treatment Services | Clinic/Center | 1700 Airport Way S, Seattle, WA 98134-1618 | 2007-01-25 |
| 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.