Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Evergreen Dermatopathology PLLC

Organization Dermatopathology (Pathology) Physician · NPI 1700581170

Evergreen Dermatopathology PLLC provides Dermatopathology (Pathology) Physician services in Liberty Lake, Washington. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2110 N Molter Rd #112
Liberty Lake, WA 99019
Phone: (208) 277-9704
Fax: (208) 277-9704
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatopathology (Pathology) Physician (primary) Taxonomy 207ZD0900X

Record details

NPI number1700581170
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ashley Hamstra — Practice Owner · (208) 277-9704
NPI enumeratedApril 4, 2023
Last updated in NPPESApril 4, 2023
Certification dateMarch 30, 2023
Mailing address2110 N Molter Rd #112, Liberty Lake, WA 99019

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