Evergreen Dermatopathology Llc

LBN: Evergreen Dermatopathology Llc
Evergreen Dermatopathology Llc is an health care organization with primary practice located at 421 E Lakeside Ave Ste 105 , Coeur D Alene ID 83814-2848. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Dermatopathology is the primary health care specialty. Evergreen Dermatopathology Llc can be contacted via phone (208) 277-9704, or through Hamstra, Ashley Anne via phone (208) 277-9704.

Contact Information

Primary practice address
421 E Lakeside Ave Ste 105 Coeur D Alene ID 83814-2848
Phone: (208) 277-9704
Fax: (208) 277-9704
Website:
Map and Directions
Authorized official contact:
Name: Hamstra, Ashley Anne Doctor of Medicine (MD)
Phone: (208) 277-9704

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X

Profile Details

NPI number 1174187165
LBN Legal business name Evergreen Dermatopathology Llc
DBA Doing business as
Authorized official Hamstra, Ashley Anne Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 25th, 2019
Last updated Sep 6th, 2019 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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