Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Evergreen Children's Clinic

Organization Pediatric Nurse Practitioner · NPI 1750639704

Evergreen Children's Clinic is a Pediatric Nurse Practitioner in Puyallup, Washington. Licensed in Washington. Registered with an NPI since 2012.

Licensed in
WA
In the registry since
2012

Practice location Address checks out

1910 Meridian St S Ste A
Puyallup, WA 98371-7531
Phone: (253) 848-2303
Fax: (253) 848-8956
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X · Licence AP60305667 (WA)

Record details

NPI number1750639704
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Susanne Roach — Office Manager · (253) 848-2303
Other names Pediatrics Pm
NPI enumeratedAugust 23, 2012
Last updated in NPPESAugust 23, 2012
Mailing address1910 Meridian St S, Suite A, Puyallup, WA 98371-7531

Other providers in Puyallup