| Evolve Md, Pllc | |
|
19243 Forest Park Dr Ne Lake Forest Park WA 98155-2441 | |
| (206) 518-2122 | |
| Not Available |
| Full Name | Evolve Md, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 19243 Forest Park Dr Ne, Lake Forest Park, Washington |
| Authorized Official Name and Position | Jeffrey Beck (PHYSICIAN) |
| Authorized Official Contact | 2065182122 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolve Md, Pllc 19243 Forest Park Dr Ne Lake Forest Park WA 98155-2441 Ph: () - | Evolve Md, Pllc 19243 Forest Park Dr Ne Lake Forest Park WA 98155-2441 Ph: (206) 518-2122 |
| NPI Number | 1578222592 |
|---|---|
| Provider Enumeration Date | 12/17/2021 |
| Last Update Date | 12/17/2021 |
| Medicare PECOS PAC ID | 3375934482 |
|---|---|
| Medicare Enrollment ID | O20220720003217 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578222592 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Jeffrey Chandler Beck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205078896 PECOS PAC ID: 0446494686 Enrollment ID: I20220720003278 |
Lake Forest Park Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17191 Bothell Way Ne, Lake Forest Park, WA 98155 Phone: 206-365-6768 Fax: 206-364-5418 |