Provider Demographics
NPI:1942921416
Name:EVERGREEN, JOSHUA CAL (LMHCA)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:CAL
Last Name:EVERGREEN
Suffix:
Gender:M
Credentials:LMHCA
Other - Prefix:
Other - First Name:JOSHUA
Other - Middle Name:MICHAEL
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12991 166TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-8254
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26401 NE RICHARDSON ST # 201
Practice Address - Street 2:
Practice Address - City:DUVALL
Practice Address - State:WA
Practice Address - Zip Code:98019-5030
Practice Address - Country:US
Practice Address - Phone:425-224-6123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61332519101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health