EVERGREEN EYE CENTER INC., P.S. (NPI# 1881763373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881763373 |
| Entity Type | Organization |
| Organization Name | EVERGREEN EYE CENTER INC., P.S. |
| Other Organization Name | EVERGREEN EYE CENTER OF FEDERAL WAY INC., P.S. |
| Practice Address |
2820 Griffin Ave Ste 101 Enumclaw WA 98022-2373 |
| Mailing Address |
Po Box 25020 Federal Way WA 98093-2020 |
| Practice Telephone | 3608024549 |
| Practice Fax Number | 3608258354 |
| Mailing Telephone | 2062122100 |
| Mailing Fax Number | 2062122174 |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JOHN STEVEN JARSTAD (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2062122100 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
| X | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | KCM | EV8144 | 01 |
| WA | AETNA | 0870427 | 01 |
| WA | NBN | WA0527 | 01 |
| WA | 7080781 | 05 | |
| WA | CRIME VICS ENUMCLAW EEC | 891451 | 01 |
| Other Name | Type Code |
|---|---|
| Evergreen Eye Center of Federal Way Inc., P.S. | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346319852 | Evergreen Eye Center Inc., P.s. | Optometrist | 700 M St Ne, Auburn, WA 98002-4586 | 2006-11-07 |
| 1538238043 | Evergreen Eye Center Inc., P.s. | Optometrist | 15153 5th Ave Sw, Burien, WA 98166-3072 | 2006-11-07 |
| 1104465012 | Evergreen Eye Center Inc., P.s. | Clinic/Center | 502 S M St, Tacoma, WA 98405-3728 | 2019-12-26 |
| 1407401920 | Evergreen Eye Center Inc., P.s. | Optometrist | 502 S M St, Tacoma, WA 98405-3728 | 2019-08-02 |
| Street Address |
2820 GRIFFIN AVE STE 101 |
| City | ENUMCLAW |
| State | WA |
| Zip Code | 98022-2373 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023416286 | Ankle & Foot Specialists of Puget Sound, Ps | Podiatrist | 2820 Griffin Ave Ste 101, Enumclaw, WA 98022-2373 | 2014-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558993725 | Megan's Massage and Esthetics LLC | Massage Therapist | 709 Griffin Ave, Enumclaw, WA 98022 | 2020-02-06 |
| 1154883494 | Nicola Given | Registered Nurse | 1818 Cole Street, Enumclaw, WA 98022 | 2019-04-04 |
| 1770099988 | Christopher P Koontz, Dds, Ps | Dentist | 2617 Griffin Ave, Enumclaw, WA 98022 | 2017-12-26 |
| 1487050977 | Hunter Chlebowski | Massage Therapist | 1453 Chinook Ave., Enumclaw, WA 98022 | 2014-11-10 |
| 1194156257 | James Kraft Symonds | Family Medicine | 1605 Washington Ave, Enumclaw, WA 98022 | 2013-11-27 |
| 1508209420 | Terri Lynn Kilbourne | Specialist | 1710 Railroad Street, Enumclaw Day Spa, Enumclaw, WA 98022 | 2013-04-10 |
| 1679824783 | Cortney Lauren Adams | Massage Therapist | 1156 Griffin Ave, Suite 209, Enumclaw, WA 98022 | 2012-09-28 |
| 1477828226 | Chella Bear Plastiras | Speech-Language Pathologist | 275 Peterson Drive East, Enumclaw, WA 98022 | 2012-03-13 |
| 1003186693 | Travis David Burt | Specialist | 1838 Porter St, Enumclaw, WA 98022 | 2012-01-12 |
| 1740590884 | Justin Andrew Bergstrom | Chiropractor | 2627 Griffin Ave., Enumclaw, WA 98022 | 2010-10-07 |
| Find all providers in zip 98022 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093918013 | Paul Shepherd | Optometrist | 2726 Griffin Ave Ste B, Enumclaw, WA 98022-2362 | 2007-06-07 |
| 1720195910 | Mark A Seaburg | Optometrist | 2823 Griffin Ave, Enumclaw, WA 98022-2322 | 2006-08-24 |
| 1841232121 | Enumclaw Family Optometry Clinic Ps | Optometrist | 2726 Griffin Ave, Ste B, Enumclaw, WA 98022-2362 | 2006-06-12 |
| 1043718257 | Enumclaw Vision Clinic Pllc | Optometrist | 2823 Griffin Ave, Enumclaw, WA 98022-2322 | 2018-01-23 |
| 1649644576 | Alexander Shepherd | Optometrist | 2726 Griffin Ave Ste B, Enumclaw, WA 98022-2362 | 2015-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215544101 | Destiny Nicole Mccoy | Optometrist | 19400 108th Ave Se Ste 202, Kent, WA 98031-0108 | 2020-09-25 |
| 1598370371 | Optometry Medical Group Inc | Optometrist | 1721 22nd Ave, Seattle, WA 98122-3324 | 2020-09-09 |
| 1962011320 | Kristine Marie Hackett | Optometrist | 19301 Se 34th St Ste 104, Camas, WA 98607-8881 | 2020-07-30 |
| 1245857044 | Minha Lee | Optometrist | 1468 158th Pl Ne, Bellevue, WA 98008-2782 | 2020-06-29 |
| 1437774734 | Vision Plus of Barkley Pllc | Optometrist | 2900 Woburn St Ste 101, Bellingham, WA 98226-3865 | 2020-06-11 |
| 1558985671 | Tiffany Lundberg | Optometrist | 2010 W Lincoln Ave Ste 1, Yakima, WA 98902-2413 | 2020-06-04 |
| 1801423041 | Jayeon Vision | Optometrist | 13909 Meridian E Ste A3, Puyallup, WA 98373-9180 | 2020-03-26 |
| 1124653464 | James Phelan | Optometrist | 14 N. Vernon Ave., Deer Park, WA 99006 | 2020-03-06 |
| 1942832845 | Trinity Vision Pllc | Optometrist | 4750 N Division St Ste 282, Spokane, WA 99207-1433 | 2020-02-07 |
| 1104464536 | Washington Eyes, LLC | Optometrist | 5011 W Lowell Ave Ste 120, Spokane, WA 99208-8587 | 2019-12-17 |
| 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.