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Organization
EVERGREEN EYE CENTER, PLLC
Active
Organization
EVERGREEN EYE CENTER, PLLC
Active
Parent organization
EYE ASSOCIATES NORTHWEST, PLLC
Other names
Eye Associates Northwest Surgery Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
EYE ASSOCIATES NORTHWEST, PLLC
Authorized official
GARY WHAKUK CHUNG MD (AUTHORIZED OFFICIAL/PHYSICIAN)
(206) 212-2100
Entity
Organization
Contact information
Practice address
1455 NW LEARY WAY, SUITE 300, SEATTLE, WA 98107-5136
(206) 342-6041
(206) 781-8693
Mailing address
1101 MADISON ST, SUITE 600, SEATTLE, WA 98104-1306
(206) 215-2004
(206) 215-2055
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7094410
—
WA
01
—
LABOR & INDUSTRIES
0014585
WA
Enumeration date
04/19/2006
Last updated
05/30/2024
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