# EVERGREEN NEUROLOGY & NEURODIAGNOSTIC PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ROMAN L KUTSY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1851572564
- **Legal business name:** ROMAN L KUTSY
- **Authorized official:** MRS. CHARIS J YATES (BILLING)
- **Authorized official phone:** (425) 259-5121

## Contact information

- **Practice address:** 2326 RUCKER AVE, EVERETT, WA 98201-2723
- **Practice address phone:** (425) 259-5121
- **Practice address fax:** (425) 252-2189
- **Mailing address:** 2320 RUCKER AVE, EVERETT, WA 98201-2723
- **Mailing address phone:** (425) 259-5121
- **Mailing address fax:** (425) 252-2189

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | MD00032822 | WA | Yes |

## Other

- **Enumeration date:** 11/21/2007
- **Last updated:** 11/21/2007