| Evergreen Family Medicine, Inc., P.s. | |
|
1408 State Ave Ne Suite 108 Olympia WA 98506-4481 | |
| (360) 705-4436 | |
| Not Available |
| Full Name | Evergreen Family Medicine, Inc., P.s. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1408 State Ave Ne, Olympia, Washington |
| Authorized Official Name and Position | Marius Lambert Laumans (PRESIDENT) |
| Authorized Official Contact | 3607054436 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Family Medicine, Inc., P.s. 1408 State Ave Ne Suite 108 Olympia WA 98506-4481 Ph: (360) 705-4436 | Evergreen Family Medicine, Inc., P.s. 1408 State Ave Ne Suite 108 Olympia WA 98506-4481 Ph: (360) 705-4436 |
| NPI Number | 1841492105 |
|---|---|
| Provider Enumeration Date | 05/31/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841492105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MD00047285 (Washington) | Primary |
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