# PUGET SOUND GASTROENTEROLOGY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Evergreen Endoscopy Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447212337
- **Authorized official:** ALAN OLIVER CEO (CEO)
- **Authorized official phone:** (786) 530-3820

## Contact information

- **Practice address:** 11800 NE 128TH ST, SUITE 100, KIRKLAND, WA 98034-7208
- **Practice address phone:** (425) 899-4500
- **Practice address fax:** (425) 899-4510
- **Mailing address:** PO BOX 34888, SEATTLE, WA 98124-1888
- **Mailing address phone:** (425) 977-4620
- **Mailing address fax:** (425) 745-9836

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/05/2006
- **Last updated:** 05/16/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0155305 | LABOR AND INDUSTRIES | WA |
| 05 | — | 1044235 | — | WA |