Evergreen Pediatric Clinic Ps
Pediatric Adolescent Medicine
Evergreen Pediatric Clinic Ps is a Vancouver, Washington based Pediatric center with medical specialization in
Pediatric Adolescent Medicine.
It is located at
505 Ne 87th Ave, Ste 120, Vancouver, Washington - 98664-1989. They can be contacted on phone at
360-892-1635 and fax number 360-892-3146.
NPI number (Unique professional ID) for Evergreen Pediatric Clinic Ps is
1144343773 which was assigned by NPPES on 09 Apr, 2007 and it was last updated on 21 Feb, 2020.
Evergreen Pediatric Clinic Ps license number is
601 115 723 for Pediatrics Adolescent Medicine (2080A0000X) in Washington.
Evergreen Pediatric Clinic Ps specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Evergreen Pediatric Clinic Ps basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Evergreen Pediatric Clinic Ps |
|---|
Business Address:
Evergreen Pediatric Clinic Ps address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 505 Ne 87th Ave, Ste 120
Vancouver, WA, 98664-1989
United States |
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| Phone Number : | 360-892-1635 |
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| Fax Number : | 360-892-3146 |
|---|
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1144343773 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 09 Apr, 2007 |
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| Last Updated On : | 21 Feb, 2020 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Teri Bryant |
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| Official Title or Position : | OFFICE MANAGER |
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| Phone Number : | 360-892-1635 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Evergreen Pediatric Clinic Ps are as mentioned. Primary taxonomy code for Evergreen Pediatric Clinic Ps is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | 601 115 723 | WA |
Legacy Identifiers:
Other legacy medical identifiers of Evergreen Pediatric Clinic Ps such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 7033186 | MEDICAID | WA | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 505 Ne 87th Ave, Ste 120
Vancouver, WA, 98664-1989
United States |
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| Phone Number : | 360-892-1635 |
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| Fax Number : | 360-892-3146 |
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Business Location:
Patients can refer following map for directions to
Evergreen Pediatric Clinic Ps practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.