Family Medicine
EVERGREEN CLINIC LLC
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1689210551 · enumerated 2019-11-25 · record updated 2020-01-13. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: IGNACIO GONZALEZ, Administrator · (801) 850-1958
Addresses and phones
- Practice location 1561 W 7000 S STE 100, WEST JORDAN, UT, 84084-3556 (801) 850-1958 Fax (801) 747-6881 Google Maps Apple Maps OpenStreetMap
- Mailing address PO BOX 9193, MIDVALE, UT, 84047-9170 (801) 850-1958 Google Maps Apple Maps OpenStreetMap
Specialties
- Family Medicine 207Q00000X · Primary
In this directory
Locations and evidence
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Practice location
WEST JORDAN, UT, 840843556
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.