Organization
EVERGREEN UROLOGY CONSULTANTS LLC
Active
Parent organization
EVERGREEN UROLOGY CONSULTANTS LLC
Other names
Athena Urolgoy
Organization subpart
Yes
Provider details
NPI number
Legal business name
EVERGREEN UROLOGY CONSULTANTS LLC
Authorized official
LORA PLASKON MD (OWNER)
(425) 392-8611
Entity
Organization
Contact information
Practice address
6520 226TH PL SE, SUITE 205, ISSAQUAH, WA 98027-8969
(425) 392-8611
(425) 392-9012
Mailing address
6520 226TH PL SE, SUITE 205, ISSAQUAH, WA 98027-8969
(425) 392-8611
(425) 392-9012
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG3321
RAILROAD MEDICARE
WA
Enumeration date
10/05/2006
Last updated
02/21/2008
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