# EVERGREEN EYE CENTER, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EYE ASSOCIATES NORTHWEST, PLLC
- **Other names:** Eye Associates Northwest Surgery Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1184689408
- **Legal business name:** EYE ASSOCIATES NORTHWEST, PLLC
- **Authorized official:** GARY WHAKUK CHUNG MD (AUTHORIZED OFFICIAL/PHYSICIAN)
- **Authorized official phone:** (206) 212-2100

## Contact information

- **Practice address:** 1455 NW LEARY WAY, SUITE 300, SEATTLE, WA 98107-5136
- **Practice address phone:** (206) 342-6041
- **Practice address fax:** (206) 781-8693
- **Mailing address:** 1101 MADISON ST, SUITE 600, SEATTLE, WA 98104-1306
- **Mailing address phone:** (206) 215-2004
- **Mailing address fax:** (206) 215-2055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 04/19/2006
- **Last updated:** 05/30/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7094410 | — | WA |
| 01 | — | LABOR & INDUSTRIES | 0014585 | WA |