| NPI | 1629179890 |
|---|---|
| Doing Business As | EVERGREEN MEDICAL GROUP KENMORE |
| Entity Type | Organization |
| Authorized Contact | ROBERT MALTE CEO 425-899-2610 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2011-01-04 |