EVERGREEN PEDIATRIC CLINIC PS – Pediatric Adolescent Medicine Physician, NPI 1144343773

EVERGREEN PEDIATRIC CLINIC PS is a healthcare provider. based in Vancouver, Washington. specializing in Pediatric Adolescent Medicine Physician. The organization holds a License No. 601 115 723 (WA). The NPI Number for EVERGREEN PEDIATRIC CLINIC PS is 1144343773

Main info

Organization
Name
EVERGREEN PEDIATRIC CLINIC PS
NPI
1144343773
Phone
(360) 892-1635
Address
505 NE 87TH AVE
Authorized Official
TERI BRYANT OFFICE MANAGER
Enumeration Date
9 April 2007
Last Update Date
21 February 2020
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

Provider Addresses for EVERGREEN PEDIATRIC CLINIC PS

  • 505 NE 87TH AVE

    STE 120

    VANCOUVER, WA 986641989

    Phone: (360) 892-1635

    Fax: (360) 892-3146

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98664)

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Reviews

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Frequently asked questions

How is EVERGREEN PEDIATRIC CLINIC PS identified in CMS data?
CMS-hosted NPPES data lists EVERGREEN PEDIATRIC CLINIC PS with NPI 1144343773.
Is EVERGREEN PEDIATRIC CLINIC PS listed as active for patients and plans?
The listing shows EVERGREEN PEDIATRIC CLINIC PS as active in the NPI system.
What is EVERGREEN PEDIATRIC CLINIC PS's primary classification?
Pediatric Adolescent Medicine Physician is the headline specialty for EVERGREEN PEDIATRIC CLINIC PS here. Clinical services aligned with this taxonomy classification.
What area does EVERGREEN PEDIATRIC CLINIC PS serve?
EVERGREEN PEDIATRIC CLINIC PS's listing highlights Vancouver, Washington; more addresses can appear in NPPES.
What does 'Organization' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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