| NPI | 1154400166 |
|---|---|
| Doing Business As | EVERGREEN DERMATOLOGY CENTER |
| Entity Type | Organization |
| Authorized Contact | JOANNA B SLOAN Owner 425-899-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: WA MD00029104) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-07-27 |