NPI 1477207272 · live from the CMS NPI Registry
Evergreen Dermatology LLC
Dermatology in Springfield, OR. National Provider Identifier 1477207272, active.
NPI record
| NPI | 1477207272 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 21 Hayden Bridge Way, Springfield, OR 97477 |
| Practice phone | 541-600-2017 |
| Enumerated | February 10, 2022 |
| Last updated | January 30, 2023 |
| Authorized official | Lindsey Fix, Physician |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology primary | 207N00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.