| Evergreen Family Medicine, Pc | |
|
1937 W Harvard Ave Roseburg OR 97471-2720 | |
| (541) 677-7200 | |
| (541) 229-3309 |
| Full Name | Evergreen Family Medicine, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1937 W Harvard Ave, Roseburg, Oregon |
| Authorized Official Name and Position | Kimberly Tyree (COO) |
| Authorized Official Contact | 5412293332 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Family Medicine, Pc 2570 Nw Edenbower Blvd Ste 100 Roseburg OR 97471-6214 Ph: (541) 677-7200 | Evergreen Family Medicine, Pc 1937 W Harvard Ave Roseburg OR 97471-2720 Ph: (541) 677-7200 |
| NPI Number | 1568434025 |
|---|---|
| Provider Enumeration Date | 02/07/2006 |
| Last Update Date | 03/24/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568434025 | NPI | - | NPPES |
| J8799-01 | Other | OR | GROUP PACIFIC SOURCE |
| 213560 | Medicaid | OR | |
| 610550200 | Other | OR | GROUP OWCP |
| 845023000 | Other | OR | GROUP BLUE CROSS |
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