Evergreen Supported Living
NPI 1124767587 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Bellingham, WA
Provider details
- NPI number
- 1124767587
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Zay Mcshane, Executive Director(360) 671-5898
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
- Behavior Technician106S00000X
Behavioral Health & Social Service Providers
- Case Management Agency251B00000X
Agencies
Agencies
- In Home Supportive Care Agency253Z00000X
Agencies
- Home Health Aide374U00000X
Nursing Service Related Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 1970 Fraser St Apt 106Bellingham, WA 98229-3794Phone: (360) 671-5898
Registry dates
- Enumerated
- 2022-06-02
- Last updated
- 2022-06-02
- Certified
- 2022-06-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.