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5920 Evergreen Way Suite E Everett WA 98203 | |
| (425) 355-2330 | |
| (425) 355-2336 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5920 Evergreen Way Suite E, Everett, Washington |
| Authorized Official Name and Position | Ekaterina Malinovska (OWNER) |
| Authorized Official Contact | 4253552330 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5920 Evergreen Way Suite E Everett WA 98203 Ph: (425) 355-2330 | 5920 Evergreen Way Suite E Everett WA 98203 Ph: (425) 355-2330 |
| NPI Number | 1922545276 |
|---|---|
| Provider Enumeration Date | 01/25/2017 |
| Last Update Date | 01/25/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922545276 | NPI | - | NPPES |
| 2067990 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Washington) | Primary |
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