Organization
EVERGREEN DERMATOPATHOLOGY LLC
Active
Organization
EVERGREEN DERMATOPATHOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASHLEY ANNE HAMSTRA MD (OWNER)
(208) 277-9704
Entity
Organization
Contact information
Practice address
421 E LAKESIDE AVE STE 105, COEUR D ALENE, ID 83814-2848
(208) 277-9704
(208) 277-9704
Mailing address
2151 N MAIN ST STE 248, COEUR D ALENE, ID 83814-5773
(843) 822-5550
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207ND0900X
Dermatopathology Physician
Primary
—
—
Other
Enumeration date
04/25/2019
Last updated
09/06/2019
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up