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

Evergreen Family Medicine, PC

Organization Emergency Medicine Physician · NPI 1417929050

Evergreen Family Medicine, PC is an Emergency Medicine Physician in Roseburg, Oregon. Works from 2 locations. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
2
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2570 NW Edenbower Blvd Ste 100
Roseburg, OR 97471-6214
Phone: (541) 229-3301
Fax: (541) 677-7462
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1937 W Harvard Ave, Roseburg, OR 97471-2720 — (541) 677-7200

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Emergency Medicine Physician Taxonomy 207P00000X

Record details

NPI number1417929050
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kimberly Tyree — Coo · (541) 229-3332
NPI enumeratedFebruary 7, 2006
Last updated in NPPESJuly 22, 2025
Certification dateJuly 22, 2025
Mailing address2570 Nw Edenbower Blvd, Ste 100, Roseburg, OR 97470-6214

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