| Evergreen Neurology Clinic, Pllc | |
|
12303 Ne 130th Ln Suite 325 Kirkland WA 98034-3099 | |
| (425) 822-1214 | |
| Not Available |
| Full Name | Evergreen Neurology Clinic, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 12303 Ne 130th Ln, Kirkland, Washington |
| Authorized Official Name and Position | Raymond Park (OWNER) |
| Authorized Official Contact | 4258221214 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Neurology Clinic, Pllc Po Box 69737 Seattle WA 98168-8737 Ph: (206) 431-0138 | Evergreen Neurology Clinic, Pllc 12303 Ne 130th Ln Suite 325 Kirkland WA 98034-3099 Ph: (425) 822-1214 |
| NPI Number | 1174710966 |
|---|---|
| Provider Enumeration Date | 09/26/2007 |
| Last Update Date | 02/29/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174710966 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (Washington) | Primary |
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