EVERGREEN NEUROLOGY CLINIC, PLLC
NPI 1174710966
Psychiatry & Neurology - Neurology in Kirkland, WA

Active since September 26, 2007
12303 NE 130TH LN, SUITE 325, KIRKLAND, WA 98034(425) 822-1214 Get Directions Write a Review

NPPES record last updated: February 29, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Evergreen Neurology Clinic, Pllc NPPES

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

EVERGREEN NEUROLOGY CLINIC, PLLC (NPI 1174710966) is a healthcare organization registered as a neurology in Kirkland, Washington and active in the NPI registry since September 2007. The organization lists Raymond Park, Owner, as its authorized official.

NPPES Registry Identity

NPI1174710966
Entity TypeOrganization
Primary Taxonomy2084N0400X
Legal Business NameEVERGREEN NEUROLOGY CLINIC, PLLC
Location Address12303 NE 130TH LN, SUITE 325Kirkland, WA 98034-3099
Mailing AddressPo Box 69737Seattle, WA 98168-8737 · (206) 431-0138 · Fax (206) 246-5819
Organization SubpartNo
Authorized OfficialRaymond ParkOwner · (425) 822-1214
Enumeration DateSeptember 26, 2007
Last NPPES UpdateFebruary 29, 2008
NPI 1174710966 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
Definition

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

12303 NE 130TH LN, Kirkland, WA 98034

Other Identifiers 1

Medicare PING8869704WA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

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

Nurse Practitioner (Family)
12303 NE 130TH LN, STE400
KIRKLAND, WA 98034
Physician Assistant (Medical)
12303 NE 130TH LN, SUITE 550
KIRKLAND, WA 98034
Specialist
12303 NE 130TH LN, SUITE 400
KIRKLAND, WA 98034
Obstetrics & Gynecology
12303 NE 130TH LN, STE 400
KIRKLAND, WA 98034
Nurse Practitioner (Obstetrics & Gynecology)
12303 NE 130TH LN, SUITE 500
KIRKLAND, WA 98034
Counselor
12303 NE 130TH LN, STE 420
KIRKLAND, WA 98034
Obstetrics & Gynecology (Gynecology)
12303 NE 130TH LN, SUITE 420
KIRKLAND, WA 98034
Pharmacist (Pharmacotherapy)
12303 NE 130TH LN, SUITE120
KIRKLAND, WA 98034

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 Neurology Clinic, PLLC's NPI number?

The NPI number for Evergreen Neurology Clinic, PLLC is 1174710966. It was assigned to this organization in the NPPES registry on September 26, 2007.

Where is Evergreen Neurology Clinic, PLLC located?

Evergreen Neurology Clinic, PLLC is located at 12303 NE 130th Ln Suite 325, Kirkland, WA 98034. The listed phone number is (425) 822-1214.

What is Evergreen Neurology Clinic, PLLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

When was this NPI record last updated?

The NPPES record for Evergreen Neurology Clinic, PLLC was last updated on February 29, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.