Healthcare Provider Details

I. General information

NPI: 1932063211
Provider Name (Legal Business Name): EVERGREEN PRIMARY CARE COLLABORATIVE P LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1377 R ST NW STE 200
WASHINGTON DC
20009-6293
US

IV. Provider business mailing address

1377 R ST NW STE 200
WASHINGTON DC
20009-6293
US

V. Phone/Fax

Practice location:
  • Phone: 202-745-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ALISON HUFFSTETLER
Title or Position: OWNER
Credential: MD
Phone: 757-303-2254