| Evergreen Medical Group Sammamish | |
|
22850 Ne 8th St Ste 103 Sammamish WA 98074-7256 | |
| (425) 898-0305 | |
| (425) 898-8825 |
| Full Name | Evergreen Medical Group Sammamish |
|---|---|
| Speciality | Family Medicine |
| Location | 22850 Ne 8th St, Sammamish, Washington |
| Authorized Official Name and Position | Robert Malte (CEO) |
| Authorized Official Contact | 4258992610 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Medical Group Sammamish Po Box 34036 Seattle WA 98124-1036 Ph: (425) 899-3292 | Evergreen Medical Group Sammamish 22850 Ne 8th St Ste 103 Sammamish WA 98074-7256 Ph: (425) 898-0305 |
| NPI Number | 1417058694 |
|---|---|
| Provider Enumeration Date | 09/26/2006 |
| Last Update Date | 01/04/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417058694 | NPI | - | NPPES |
| CG2833 | Other | WA | MEDICARE RAILROAD |
| CG8137 | Other | WA | MEDICARE RAILROAD |
| 7099849 | Medicaid | WA | |
| CJ9678 | Other | WA | MEDICARE RAILROAD |
| CQ2437 | Other | WA | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Sammamish Diabetes And Lipid Clinic, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3854 E Lake Sammamish Pkwy Ne, Sammamish, WA 98074 Phone: 425-996-7047 Fax: 425-996-7087 | |
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