Evergreen Telepsychiatry PLLC
Clinic/Center in Kirkland, WA. Organization (NPI-2).
NPI number1205593449
StatusActive
Last updated in NPPESSep 6, 2023
Details
- NPI
- 1205593449
- Entity type
- Organization (NPI-2)
- Legal business name
- Evergreen Telepsychiatry PLLC
- Organization subpart
- No
- Enumeration date
- Nov 23, 2021
- Certification date
- Nov 29, 2021
- Last updated
- Sep 6, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Practice location
11335 Ne 122nd Way Ste 105Kirkland, WA 98034-6933
Phone 206-451-7150
Mailing address
11335 Ne 122nd Way Ste 105Kirkland, WA 98034-6933
Phone 206-451-7150
Authorized official
Joseph Michael Ungvarsky
Founder/Pmhnp-Bc
5704173318
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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