Evergreen Children's Clinic
NPI 1750639704ActiveOrganization· Nurse Practitioner, Pediatrics· Puyallup, WA
Nurse Practitioner, Pediatrics in Puyallup, Washington, registered in NPPES in August 2012. The authorized official on file is Susanne I. Roach, Office Manager.
Overview
| NPI | 1750639704 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 23, 2012 |
| Last updated in NPPES | Aug 23, 2012 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Pediatrics Primary | 363LP0200X | AP60305667 | WA |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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