Evergreen Dermatopathology PLLC
NPI 1700581170ActiveOrganization· Pathology, Dermatopathology· Liberty Lake, WA
Pathology, Dermatopathology in Liberty Lake, Washington, registered in NPPES in April 2023. The authorized official on file is Ashley Anne Hamstra, MD, Practice Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1700581170 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 4, 2023 |
| Last updated in NPPES | Apr 4, 2023 |
| Certified by provider | Mar 30, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pathology, Dermatopathology Primary | 207ZD0900X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (WA) |
|---|