Evergreen Nephrology Associates Pllc
LBN: Evergreen Nephrology Associates Pllc
Evergreen Nephrology Associates Pllc is an health care organization with primary practice located at 1708 Yakima Ave Suite 107, Tacoma WA 98405-5307. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty.
Evergreen Nephrology Associates Pllc can be contacted via phone (253) 272-5881, or through Martin, Thomas Jacob via phone (253) 272-5881.
Contact Information
Primary practice address
1708 Yakima Ave Suite 107
Tacoma WA 98405-5307
Phone: (253) 272-5881
Fax: (253) 383-0161
Website:
Authorized official contact:
Name: Martin, Thomas Jacob Doctor of Medicine (MD)
Phone: (253) 272-5881
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | MD00028956 | Washington |
Profile Details
| NPI number | 1942254362 |
|---|---|
| LBN Legal business name | Evergreen Nephrology Associates Pllc |
| DBA Doing business as | |
| Authorized official | Martin, Thomas Jacob Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 20th, 2006 |
| Last updated | Aug 22nd, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942254362 | NPPES |
| Washington | MEDICAID | 7089881 |
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