# EVERGREEN PARK AFH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912794819
- **Authorized official:** ADRIAN BALASA (OFFICE ADMINISTRATOR)
- **Authorized official phone:** (425) 753-2416

## Contact information

- **Practice address:** 17126 SE 29TH PL, BELLEVUE, WA 98008-5600
- **Practice address phone:** (206) 660-1273
- **Mailing address:** 17126 SE 29TH PL, BELLEVUE, WA 98008-5600
- **Mailing address phone:** (206) 660-1273

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 04/23/2025
- **Last updated:** 04/23/2025