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General NPI Number Information
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NPI Number | 1467348177
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Entity Type | Organization
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Legal Business Name | EVERGREEN PSYCHIATRY PLLC
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 2594 S LEWIS WAY UNIT E
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City | LAKEWOOD
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State | CO
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Zip | 80227-2839
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Country | US
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Telephone | 720-696-9502
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Fax | 720-796-7866
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Provider Business Mailing Address
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Address Line | 7834 W OXFORD CIR
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City | LAKEWOOD
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State | CO
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Zip | 80235-1937
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Country | US
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Telephone | 970-768-4465
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HUSAM SAIFULDEEN SALIH
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Credential | PMHNP-BC
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Telephone | 970-768-4465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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