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Evergreen Children'S Clinic, Pllc

Pediatric Adolescent Medicine Physician in Puyallup, WA · enumerated 2006 · authorized official Susanne Roach, Office Manager.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1568527539

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Registry record

Entity type Organization (Type 2)
Legal business name Evergreen Children'S Clinic, Pllc
Other name <Unavail>
Practice address 1910 S Meridian, Suite A, Puyallup, WA, 98371
Phone (253) 848-2303
Fax (253) 848-8956
Enumeration date Dec 27, 2006
Last updated in NPPES Aug 22, 2020

Taxonomy & classification

2080A0000X Pediatric Adolescent Medicine Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Susanne Roach
Title Office Manager
Phone (253) 848-2303

Other identifiers

Identifier Type State Issuer
7054364 Medicaid WA -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2020-08-22. Verify at npiregistry.cms.hhs.gov.
Where is Evergreen Children'S Clinic, Pllc located?
The practice location on file with NPPES is in Puyallup, WA.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-08-22.