OrganizationActive
Evergreen Pediatric Clinic Ps
NPI 1144343773 · Pediatric Adolescent Medicine Physician · Vancouver, WA
Provider details
- NPI number
- 1144343773
- Entity type
- Organization
- Primary specialty
- Pediatric Adolescent Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Teri Bryant, Office Manager(360) 892-1635
- License
- 601 115 723 (WA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
505 Ne 87th Ave
Ste 120
Vancouver, WA 98664-1989
Phone: (360) 892-1635
Fax: (360) 892-3146
Approximate (ZIP-level) locationGet directions
Mailing address
505 Ne 87th Ave
Vancouver, WA 98664-1989
Registry dates
- Enumerated
- 2007-04-09
- Last updated
- 2020-02-21
- Certified
- 2020-02-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.