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EVERGREEN PARK AFH
NPI 1912794819
Custodial Care Facility - Adult Care Home in Bellevue, WA

Active since April 23, 2025CLIA Certified · 2 labs
17126 SE 29TH PL, BELLEVUE, WA 98008(206) 660-1273 Get Directions Write a Review

NPPES record last updated: April 23, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Evergreen Park Afh NPPES

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

EVERGREEN PARK AFH (NPI 1912794819) is a healthcare organization registered as an adult care home in Bellevue, Washington and active in the NPI registry since April 2025. The organization holds 2 active CLIA laboratory certificates, maintains 3 additional practice locations, and lists Adrian Balasa, Office Administrator, as its authorized official.

NPPES Registry Identity

NPI1912794819
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameEVERGREEN PARK AFH
Location Address17126 SE 29TH PLBellevue, WA 98008-5600
Mailing Address17126 Se 29th PlBellevue, WA 98008-5600 · (206) 660-1273
Phone(206) 660-1273
Organization SubpartNo
Authorized OfficialAdrian BalasaOffice Administrator · (425) 753-2416
Enumeration DateApril 23, 2025
NPPES CertifiedApril 23, 2025
✔ NPI 1912794819 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
Definition
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
17126 SE 29TH PL, Bellevue, WA 98008
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Secondary Practice Locations 3

Location 1142 S 295th PlFederal Way, WA 98003-3659 · Phone (253) 839-9438
Location 232020 11th Ave SWFederal Way, WA 98023-5548 · Phone (253) 344-1139
Location 37520 E Green Lake Dr NSeattle, WA 98103-4912 · Phone (206) 985-2048

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 50D2292949

Evergreen Park #4 · Federal Way, WA
Active · expires Apr 4, 2028
CLIA Number50D2292949
Laboratory TypeAfh
Certificate Effective DateNovember 1, 2023
Certificate Expiration DateApril 4, 2028
Laboratory DirectorSayh Saida
Laboratory Phone(253) 839-9438
Laboratory LocationEvergreen Park #4142 S 295th Pl, Federal Way, WA 98003
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 50D2292953

Evergreen Park West Campus · Federal Way, WA
Active · expires Apr 4, 2028
CLIA Number50D2292953
Laboratory TypeAfh
Certificate Effective DateNovember 1, 2023
Certificate Expiration DateApril 4, 2028
Laboratory DirectorTheresa Kaufman
Laboratory Phone(253) 344-1139
Laboratory LocationEvergreen Park West Campus32020 11th Ave SW, Federal Way, WA 98023
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

MARIJANA MORROW
Custodial Care Facility (Adult Care Home)
17126 SE 29TH PL
BELLEVUE, WA 98008
King County (206) 660-1273

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 Park Afh's NPI number?

The NPI number for Evergreen Park Afh is 1912794819. It was assigned to this organization in the NPPES registry on April 23, 2025.

Where is Evergreen Park Afh located?

Evergreen Park Afh is located at 17126 SE 29th Pl, Bellevue, WA 98008. The listed phone number is (206) 660-1273.

What is Evergreen Park Afh's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

Does Evergreen Park Afh 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 Evergreen Park Afh was last updated on April 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.