NPI | 1154399319 |
---|---|
Doing Business As | EVERGREEN OPTICAL |
Entity Type | Organization |
Authorized Contact | ROSA CAMPOS Credentialing Manager 206-215-2004 |
Organization Subpart ? | Yes |
Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
Enumeration Date | 2006-03-14 |
Last Update Date | 2024-01-12 |