# HRT EVERGREEN PC

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

## Provider details

- **NPI number:** 1730986035
- **Authorized official:** AMANDA WILKINSON (BUSINESS OPERATIONS DIRECTOR)
- **Authorized official phone:** (602) 796-2559

## Contact information

- **Practice address:** 11917 E BROADWAY AVE STE 102, SPOKANE VALLEY, WA 99206-6011
- **Practice address phone:** (602) 796-2559
- **Mailing address:** 10501 W GOWAN RD STE 200, LAS VEGAS, NV 89129-6602

## Taxonomy

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

## Other

- **Enumeration date:** 02/25/2025
- **Last updated:** 07/08/2025