# AWH EVERGREEN PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ageless Women's Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205726353
- **Authorized official:** AMANDA WILKINSON (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (725) 204-6055

## Contact information

- **Practice address:** 18209 STATE ROUTE 410 E STE 303, BONNEY LAKE, WA 98391-5146
- **Practice address phone:** (725) 204-6055
- **Mailing address:** 10501 W GOWAN RD STE 200, LAS VEGAS, NV 89129-6602
- **Mailing address phone:** (725) 204-6055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/08/2025
- **Last updated:** 07/08/2025