| NPI | 1700959293 |
|---|---|
| Doing Business As | EVERGREEN EYE CENTER |
| Former Legal Business Name | EVERGREEN EYE CENTER OF FEDERAL WAY INC., P.S. |
| Entity Type | Organization |
| Authorized Contact | ROSA ANGELICA CAMPOS Credentialing Manager 206-215-2004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2024-01-04 |