# EVERGREEN FAMILY MEDICINE, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Evergreen Family Medicine, Evergreen Diagnostics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568434025
- **Authorized official:** MRS. KIMBERLY TYREE (COO)
- **Authorized official phone:** (541) 229-3332

## Contact information

- **Practice address:** 1937 W HARVARD AVE, ROSEBURG, OR 97471-2720
- **Practice address phone:** (541) 677-7200
- **Practice address fax:** (541) 229-3309
- **Mailing address:** 2570 NW EDENBOWER BLVD STE 100, ROSEBURG, OR 97471-6214
- **Mailing address phone:** (541) 677-7200
- **Mailing address fax:** (541) 677-3309

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 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