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EVERGREENHEALTH
NPI 1164876322
Clinic/Center - Primary Care in Kirkland, WA

Active since April 14, 2016CLIA Certified · 2 labs
11521 NE 128TH ST, SUITE 100, KIRKLAND, WA 98034(425) 899-6797(425) 899-6808 Get Directions Write a Review

NPPES record last updated: April 14, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Evergreenhealth NPPES

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

EVERGREENHEALTH (NPI 1164876322) is a healthcare organization registered as a primary care in Kirkland, Washington and active in the NPI registry since April 2016. The organization holds 2 active CLIA laboratory certificates and lists Connie Smith, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1164876322
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameEVERGREENHEALTH
Location Address11521 NE 128TH ST, SUITE 100Kirkland, WA 98034-4317
Mailing Address11521 Ne 128th St, Suite 100Kirkland, WA 98034-4317 · (425) 899-6797 · Fax (425) 899-6808
Phone(425) 899-6797
Fax(425) 899-6808
Organization SubpartNo
Authorized OfficialConnie SmithMedical Director · (425) 899-6800
Enumeration DateApril 14, 2016
✔ NPI 1164876322 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in WA · PH60004517
11521 NE 128TH ST, Kirkland, WA 98034
Open in Google Maps ↗

CLIA Laboratory Certificates CMS CLIA 2

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 50D0630303

Evergreenhealth Urology And Urogynecology Clinic · Kirkland, WA
Active · expires Apr 4, 2028
CLIA Number50D0630303
Laboratory TypePhysician Office
Certificate Effective DateNovember 26, 2025
Certificate Expiration DateApril 4, 2028
Laboratory DirectorScott Vanappledorn
Laboratory Phone(425) 899-5800
Laboratory LocationEvergreenhealth Urology And Urogynecology Clinic12303 Northeast 130th Lane Suite 300 & 320, Kirkland, WA 98034
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 50D0630358

Evergreenhealth Primary Care, Lakeshore Totem Lake · Kirkland, WA
Active · expires Apr 4, 2028
CLIA Number50D0630358
Laboratory TypePhysician Office
Certificate Effective DateAugust 7, 2023
Certificate Expiration DateApril 4, 2028
Laboratory DirectorPratima J. Sharma
Laboratory Phone(425) 821-4040
Laboratory LocationEvergreenhealth Primary Care, Lakeshore Totem Lake12710 Totem Lake Blvd NE, Kirkland, WA 98034
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 16

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

MR. STEPHEN WALLINGFORD PRICE PA-C
Physician Assistant
11521 NE 128TH ST, SUITE 100
KIRKLAND, WA 98034
King County (425) 899-6800
DR. HENRY SU MD
Internal Medicine (Sleep Medicine)
11521 NE 128TH ST, SUITE 130
KIRKLAND, WA 98034
King County (425) 899-4280
DR. ARTHUR CALVERT ISRAEL MD
Internal Medicine (Geriatric Medicine)
11521 NE 128TH ST, SUITE 100
KIRKLAND, WA 98034
King County (425) 899-6800
ASHLEY ROHDE ARNP
Nurse Practitioner (Family)
11521 NE 128TH ST
KIRKLAND, WA 98034
King County (425) 899-6800
RYAN MICHAEL CULALA PHARM.D.
Pharmacist
11521 NE 128TH ST, STE 100
KIRKLAND, WA 98034
King County (425) 899-6800
MRS. MONIKA RAJPAL PHARM.D. R.PH
Pharmacist
11521 NE 128TH ST, SUITE 100
KIRKLAND, WA 98034
King County (425) 899-6800
KING COUNTY PUBLIC HOSPITAL DISTRICT NO 2
Internal Medicine
11521 NE 128TH ST, STE 100
KIRKLAND, WA 98034
King County (425) 899-6800
DR. VICTORIA LYNN MARXEN MD
Internal Medicine
11521 NE 128TH ST, SUITE 100
KIRKLAND, WA 98034
King County (425) 899-6800

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 Evergreenhealth's NPI number?

The NPI number for Evergreenhealth is 1164876322. It was assigned to this organization in the NPPES registry on April 14, 2016.

Where is Evergreenhealth located?

Evergreenhealth is located at 11521 NE 128th St Suite 100, Kirkland, WA 98034. The listed phone number is (425) 899-6797.

What is Evergreenhealth's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Evergreenhealth hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Evergreenhealth was last updated on April 14, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.