Evergreenhealthcare | |
12333 Ne 130th Ln Tan 415 Kirkland WA 98034-7467 | |
(425) 899-2783 | |
(425) 899-2784 |
Full Name | Evergreenhealthcare |
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Speciality | Clinic/center - Multi-specialty |
Location | 12333 Ne 130th Ln, Kirkland, Washington |
Authorized Official Name and Position | Marie A Cermak (PHARMACIST) |
Authorized Official Contact | 4258992783 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Evergreenhealthcare 12333 Ne 130th Ln Tan 415 Kirkland WA 98034-7467 Ph: (425) 899-2783 | Evergreenhealthcare 12333 Ne 130th Ln Tan 415 Kirkland WA 98034-7467 Ph: (425) 899-2783 |
NPI Number | 1588054332 |
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Provider Enumeration Date | 02/02/2015 |
Last Update Date | 02/02/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588054332 | NPI | - | NPPES |
PH00009804 | Other | WA | PHARMACY LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | PH0009804 (Washington) | Primary |
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