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Organization
EVERGREEN SURGERY CENTER, LLC
Active
Organization
EVERGREEN SURGERY CENTER, LLC
Active
Other names
Evergreen Surgical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFF TOMLIN M.D. (EXECUTIVE DIRECTOR)
(425) 899-5656
Entity
Organization
Contact information
Practice address
12333 NE 130TH LN, SUITE 500, KIRKLAND, WA 98034-7467
(425) 899-5656
(425) 899-5638
Mailing address
12333 NE 130TH LN, SUITE 500, KIRKLAND, WA 98034-7467
(425) 899-5656
(425) 899-5638
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7123631
—
WA
Enumeration date
11/09/2005
Last updated
09/20/2007
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