# EVERGREEN FOOT & ANKLE SPECIALISTS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386956704
- **Authorized official:** DR. KURT W DAVIS DPM (MANAGER)
- **Authorized official phone:** (360) 694-3668

## Contact information

- **Practice address:** 2415 SE 165TH AVE STE 104, VANCOUVER, WA 98683-4324
- **Practice address phone:** (360) 694-3668
- **Practice address fax:** (360) 882-3566
- **Mailing address:** 2415 SE 165TH AVE STE 104, VANCOUVER, WA 98683-4324
- **Mailing address phone:** (360) 694-3668
- **Mailing address fax:** (360) 882-3566

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | PO00000682 | WA | Yes |
| 332BC3200X | Customized Equipment (DME) | PO000000682 | WA | — |

## Other

- **Enumeration date:** 07/14/2010
- **Last updated:** 09/14/2010