EVERGREEN RADIA LLC
EVERGREEN RADIA LLC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1922095694, based in Kirkland, WA. It is classified under Diagnostic Radiology Physician.
Getting there
The practice address on file is 11521 NE 128TH ST SUITE 200, Kirkland, WA 98034. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 602317167 | WA | Diagnostic Radiology Physician primary |
This provider holds licence 602317167 issued in WA. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Part B Supplier - Clinic/group Practice
- PAC ID
- 4587568076
Enrolled in Medicare 29 times, across 29 states:
| State | Enrollment ID | Provider type |
|---|---|---|
| Washington | O20031125000896 | Part B Supplier - Clinic/group Practice |
| California | O20200501001503 | Part B Supplier - Clinic/group Practice |
| Hawaii | O20220110000824 | Part B Supplier - Clinic/group Practice |
| Utah | O20220627001586 | Part B Supplier - Clinic/group Practice |
| Virginia | O20220801002607 | Part B Supplier - Clinic/group Practice |
| Arizona | O20220811000481 | Part B Supplier - Clinic/group Practice |
| Oregon | O20220811002363 | Part B Supplier - Clinic/group Practice |
| Florida | O20220909000012 | Part B Supplier - Clinic/group Practice |
| Massachusetts | O20221103002799 | Part B Supplier - Clinic/group Practice |
| Texas | O20221202000482 | Part B Supplier - Clinic/group Practice |
| Georgia | O20231020002232 | Part B Supplier - Clinic/group Practice |
| Nebraska | O20231122000281 | Part B Supplier - Clinic/group Practice |
| Michigan | O20231130000851 | Part B Supplier - Clinic/group Practice |
| Missouri | O20240410000950 | Part B Supplier - Clinic/group Practice |
| District of Columbia | O20240418000021 | Part B Supplier - Clinic/group Practice |
| Alabama | O20240423000363 | Part B Supplier - Clinic/group Practice |
| North Carolina | O20240423001259 | Part B Supplier - Clinic/group Practice |
| Nevada | O20240614003382 | Part B Supplier - Clinic/group Practice |
| Pennsylvania | O20240624000191 | Part B Supplier - Clinic/group Practice |
| Iowa | O20240708003362 | Part B Supplier - Clinic/group Practice |
| Idaho | O20240711001245 | Part B Supplier - Clinic/group Practice |
| South Carolina | O20240822002990 | Part B Supplier - Clinic/group Practice |
| Colorado | O20241113002414 | Part B Supplier - Clinic/group Practice |
| Connecticut | O20250424000132 | Part B Supplier - Clinic/group Practice |
| Maryland | O20250523001155 | Part B Supplier - Clinic/group Practice |
| Oklahoma | O20250627000068 | Part B Supplier - Clinic/group Practice |
| Ohio | O20250910000164 | Part B Supplier - Clinic/group Practice |
| Tennessee | O20250919003581 | Part B Supplier - Clinic/group Practice |
| Illinois | O20251124001004 | Part B Supplier - Clinic/group Practice |
Medicare enrolment is recorded as approved under the provider type Part B Supplier - Clinic/group Practice. There are 29 separate enrolment records across 29 states (WA, CA, HI, UT, VA, AZ, OR, FL, MA, TX, GA, NE, MI, MO, DC, AL, NC, NV, PA, IA, ID, SC, CO, CT, MD, OK, OH, TN, IL). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Diagnostic Radiology covers
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. NUCC Health Care Provider Taxonomy, code 2085R0202X
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1922095694 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Sep 28, 2005 |
| Last updated | Sep 12, 2018 |
| Status | Active |
| Practice address |
11521 NE 128TH ST SUITE 200 Kirkland, WA 98034 (425) 952-6100 Fax (425) 952-6150 |
| Mailing address |
19020 33RD AVE W STE 210 Lynnwood, WA 98036 |
| Other identifiers |
7118227
· Medicaid (WA) 175238 · Other (WA) 8933574 · Other (WA) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 9 | 2 | 2 | 0 | 9 | 5 | 6 | 9 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 9 | 4 | 2 | 0 | 9 | 1 | 6 | 9 |
Sum = 66 · next multiple of 10 = 70 · check digit = 4 · actual last digit = 4
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.