1. Home
  2. Directory
  3. Washington
  4. Kirkland
  5. Eyewear Supplier
  6. NPI Profile

EVERGREEN OPTICAL
NPI 1154399319
Eyewear Supplier in Kirkland, WA

Active since March 14, 2006CLIA 50D2312078 · Waiver
11325 NE 120TH ST STE 11325, KIRKLAND, WA 98034(425) 775-0548(425) 670-6708 Get Directions Write a Review

NPPES record last updated: January 12, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 3, 2024, Aug 17, 2021 (2 updates tracked since 2021).

About Evergreen Optical NPPES

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

EVERGREEN OPTICAL (NPI 1154399319) is a healthcare organization registered as an eyewear supplier in Kirkland, Washington and active in the NPI registry since March 2006. The organization holds a CLIA Waiver certificate valid through April 4, 2028, maintains a secondary practice location in Kirkland, and lists Rosa Campos, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1154399319
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameEYE ASSOCIATES NORTHWEST, PLLC
Location Address11325 NE 120TH ST STE 11325Kirkland, WA 98034-6907
Mailing Address1101 Madison St, Ste 600Seattle, WA 98104-1306 · (206) 215-2004 · Fax (206) 215-2055
Phone(425) 775-0548
Fax(425) 670-6708
Organization SubpartYes
Authorized OfficialRosa CamposCredentialing Manager · (206) 215-2004
Enumeration DateMarch 14, 2006
Last NPPES UpdateJanuary 12, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 12, 2024
✔ NPI 1154399319 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
11325 NE 120TH ST STE 11325, Kirkland, WA 98034
Open in Google Maps ↗

Other Names 1

Doing Business AsEvergreen Optical

Secondary Practice Location 1

Location 111919 NE 128th St, Ste AKirkland, WA 98034-7204 · Phone (425) 820-6307 · Fax (425) 821-8836

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 50D2312078

Eye Associates Northwest - Edmonds · Edmonds, WA
Active · expires Apr 4, 2028
CLIA Number50D2312078
Laboratory TypePhysician Office
Certificate Effective DateOctober 3, 2024
Certificate Expiration DateApril 4, 2028
Laboratory DirectorTed Zollman
Laboratory Phone(425) 775-0548
Laboratory LocationEye Associates Northwest - Edmonds21616 76th Ave W Ste 110, Edmonds, WA 98026
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Eye Associates Northwest, PLLC's NPI number?

The NPI number for Eye Associates Northwest, PLLC is 1154399319. It was assigned to this organization in the NPPES registry on March 14, 2006. The provider is doing business as Evergreen Optical.

Where is Eye Associates Northwest, PLLC located?

Eye Associates Northwest, PLLC is located at 11325 NE 120th St Ste 11325, Kirkland, WA 98034. The listed phone number is (425) 775-0548.

What is Eye Associates Northwest, PLLC's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

Does Eye Associates Northwest, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2312078) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Eye Associates Northwest, 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.