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Organization
EVERGREEN FAMILY MEDICINE, PC
Active
Organization
EVERGREEN FAMILY MEDICINE, PC
Active
Other names
Evergreen Family Medicine, Evergreen Diagnostics
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY TYREE (COO)
(541) 229-3332
Entity
Organization
Contact information
Practice address
1937 W HARVARD AVE, ROSEBURG, OR 97471-2720
(541) 677-7200
(541) 229-3309
Mailing address
2570 NW EDENBOWER BLVD STE 100, ROSEBURG, OR 97471-6214
(541) 677-7200
(541) 677-3309
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
261Q00000X
Clinic/Center
—
NULL
261QR0200X
Radiology Clinic/Center
—
NULL
291U00000X
Clinical Medical Laboratory
—
NULL
Other
Enumeration date
02/07/2006
Last updated
03/24/2026
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