Medical Staff Services
Medical Staff Leadership
Michael Mena, MD
Medical Staff President
MFMena@evergreenhealth.com
Jan Stroh, MD
Medical Staff Vice President
JStroh@evergreenhealth.com
Chad Bentsen, MD
Past Medical Staff President
CMBentsen@evergreenhealth.com
Medical Staff Office
Christine Abraham, CPCS
Manager, Medical Staff Services
(425) 899-1891
CTAbraham@evergreenhealth.com
Lisa Anderson, CPCS
Medical Staff Coordinator
(425) 899-1772
T-LAnderson@evergreenhealth.com
Khadija Khan, CPCS
Quality Assurance Analyst
(425) 899-1897
KMKhan@evergreenhealth.com
Julie Wahl, CPCS
Medical Staff Coordinator
(425) 899-1894
JAWahl@evergreenhealth.com
Valerie Clayton
Continuing Medical Education
(425) 899-1853
VCClayton@evergreenhealth.com
Helpful External Links
Application for DEA Registration
National Provider Identifier (NPI) Application Instructions
Washington State Physician/PA Licensing Forms
Washington State Department of Health – License application, renewals, FAQ’s
MSS Review Links
Committee / Chief Review (Virtual Committee)
MD-Staff MSS Login
How do I change my last name?
With Medical Staff Services
If your last name has changed, you must first make this change on all Washington State licenses, your NPI and DEA registration (if applicable).
Once we can verify this has been completed, a name change will be generated within our office and within Epic.
NOTE: Name changes through Human Resources (for badging, payroll or other employment activities) must be done separately.
With NPPES (NPI Registration)
Step 1: login to https://nppes.cms.hhs.gov/IAWeb/login.do
- Click on My Profile
- Change last name
Step 2: https://nppes.cms.hhs.gov/#/
- Log in using same username/PW as above.
- Under Manage Provider Information, find the “Pencil” icon, and click on it. This leads to a 7 page form; change your name on page 1, and then sign and submit on page 7.
- Await confirmation email; change should occur in 24 hours if there are no issues, otherwise can take up to 30 days if more information needs to be verified.
Hospital Affiliation Verifications
To pull a verification from MD-Query, go to www.mdquery.com/evergreen
Login: evergreen
Password: query
If no letter is available for the practitioner you are verifying, please fax your request with a release to (425) 899-1898 or email to us at evgmedstaff@evergreenhealth.com.
