Provider Demographics
NPI:1467348177
Name:EVERGREEN PSYCHIATRY PLLC
Entity type:Organization
Organization Name:EVERGREEN PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HUSAM
Authorized Official - Middle Name:SAIFULDEEN
Authorized Official - Last Name:SALIH
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:970-768-4465
Mailing Address - Street 1:7834 W OXFORD CIR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80235-1937
Mailing Address - Country:US
Mailing Address - Phone:970-768-4465
Mailing Address - Fax:
Practice Address - Street 1:2594 S LEWIS WAY UNIT E
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-2839
Practice Address - Country:US
Practice Address - Phone:720-696-9502
Practice Address - Fax:720-796-7866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty