| NPI | 1922540004 |
|---|---|
| Doing Business As | EVERGREENHEALTH LAKESHORE TOTEM LAKE |
| Entity Type | Organization |
| Authorized Contact | ROBERT MALTE CEO 425-899-2610 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 213E00000X Podiatrist | |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2016-11-18 |