| Evergreen Diabetes & Endocrinology Medical Group, Pllc | |
|
13118 121st Way Ne Suite 103 Kirkland WA 98034-3004 | |
| (425) 899-6414 | |
| (425) 899-4066 |
| Full Name | Evergreen Diabetes & Endocrinology Medical Group, Pllc |
|---|---|
| Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
| Location | 13118 121st Way Ne, Kirkland, Washington |
| Authorized Official Name and Position | Edward Courtright La Cava (OWNER) |
| Authorized Official Contact | 4258996414 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Diabetes & Endocrinology Medical Group, Pllc 13118 121 Way Ne Suite 103 Kirkland WA 98034-3004 Ph: (425) 899-6414 | Evergreen Diabetes & Endocrinology Medical Group, Pllc 13118 121st Way Ne Suite 103 Kirkland WA 98034-3004 Ph: (425) 899-6414 |
| NPI Number | 1497766190 |
|---|---|
| Provider Enumeration Date | 08/10/2006 |
| Last Update Date | 07/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497766190 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 602612648 (Washington) | Primary |
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