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EVERGREEN EYE CENTER, PLLC
NPI 1104465012
Clinic/Center - Ambulatory Surgical in Tacoma, WA

Active since December 26, 2019CLIA 50D2172588 · Waiver

NPPES record last updated: January 12, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 3, 2024, Dec 30, 2019, Dec 26, 2019 (3 updates tracked since 2019).

About Evergreen Eye Center, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVERGREEN EYE CENTER, PLLC (NPI 1104465012) is a healthcare organization registered as an ambulatory surgical in Tacoma, Washington and active in the NPI registry since December 2019. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Rosa Campos, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1104465012
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameEVERGREEN EYE CENTER, PLLC
Location Address502 S M STTacoma, WA 98405-3728
Mailing Address502 S M StTacoma, WA 98405-3728 · (206) 260-2503 · Fax (855) 929-1515
Phone(800) 340-3595
Organization SubpartNo
Authorized OfficialRosa CamposCredentialing Manager · (206) 215-2004
Enumeration DateDecember 26, 2019
Last NPPES UpdateJanuary 12, 20243 updates tracked since enumeration
NPPES CertifiedJanuary 12, 2024
✔ NPI 1104465012 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
502 S M ST, Tacoma, WA 98405
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D2172588

Evergreen Eye Center · Tacoma, WA
Active · expires Apr 4, 2028
CLIA Number50D2172588
Laboratory TypePhysician Office
Certificate Effective DateSeptember 25, 2019
Certificate Expiration DateApril 4, 2028
Laboratory DirectorBrice Nicholson
Laboratory Phone(800) 340-3595
Laboratory LocationEvergreen Eye Center502 S M St, Tacoma, WA 98405
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
336 services198 patients
Removal of recurring cataract in lens capsule using a laser 66821
This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.
137 services101 patients
Complex removal of cataract with insertion of prosthetic lens 66982
This procedure involves removing a cloudy lens (cataract) from your eye and replacing it with a clear, artificial lens. It helps restore vision that has been affected by the cataract. The operation is usually done under local anesthesia.
37 services29 patients
Laser repair to improve eye fluid flow 65855
Laser repair to improve eye fluid flow is a procedure aimed at treating glaucoma. A laser is used to create a small hole in the eye's drainage system, allowing fluid to flow out more easily. This helps to lower the pressure inside the eye, reducing the risk of vision loss.
34 services19 patients
Incision to improve eye fluid flow 65820
This procedure, known as a trabeculectomy, involves creating a small opening in the eye to improve fluid flow. This can help lower eye pressure in conditions like glaucoma. It's a common, safe procedure to protect your eye health.
20 services12 patients

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ALEXANDER L. GRIGALUNAS M.D.
Ophthalmology
502 S M ST
TACOMA, WA 98405
Pierce County (253) 301-4953
JOHN T. HEFFERNAN M.D.
Ophthalmology (Ophthalmic Plastic and Reconstructive Surgery)
502 S M ST
TACOMA, WA 98405
Pierce County (206) 212-2100
CONNIE E JENSEN CRNA
Nurse Anesthetist, Certified Registered
502 S M ST, SUITE 200
TACOMA, WA 98405
Pierce County (253) 475-5433
ANDREW B KOPSTEIN MD
Ophthalmology
502 S M ST
TACOMA, WA 98405
Pierce County (253) 301-4953
TACOMA EYE SURGEONS PS
Ophthalmology
502 S M ST
TACOMA, WA 98405
Pierce County (253) 301-4953
DR. DOUGLAS A MACLEOD
Ophthalmology
502 S M ST
TACOMA, WA 98405
Pierce County (253) 627-8266
CHRISTINE MARIE HINTZ O.D.
Optometrist
502 S M ST
TACOMA, WA 98405
Pierce County (253) 627-8266
EVERGREEN EYE CENTER, PLLC
Ophthalmology
502 S M ST
TACOMA, WA 98405
Pierce County (800) 340-3595

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Evergreen Eye Center, PLLC's NPI number?

The NPI number for Evergreen Eye Center, PLLC is 1104465012. It was assigned to this organization in the NPPES registry on December 26, 2019.

Where is Evergreen Eye Center, PLLC located?

Evergreen Eye Center, PLLC is located at 502 S M St, Tacoma, WA 98405. The listed phone number is (800) 340-3595.

What is Evergreen Eye Center, PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Evergreen Eye Center, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2172588) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Evergreen Eye Center, PLLC accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Evergreen Eye Center, PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Evergreen Eye Center, PLLC was last updated on January 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.