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

Evergreen Dermatopathology PLLC

Organization Dermatopathology (Pathology) Physician · NPI 1700581170

Evergreen Dermatopathology PLLC is a Dermatopathology (Pathology) Physician in Liberty Lake, Washington. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2110 N Molter Rd #112
Liberty Lake, WA 99019
Phone: (208) 277-9704
Fax: (208) 277-9704
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatopathology (Pathology) Physician (primary) Taxonomy 207ZD0900X

Record details

NPI number1700581170
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ashley Hamstra — Practice Owner · (208) 277-9704
NPI enumeratedApril 4, 2023
Last updated in NPPESApril 4, 2023
Certification dateMarch 30, 2023
Mailing address2110 N Molter Rd #112, Liberty Lake, WA 99019

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