Organization
EVERGREEN CARDIOLOGY CARE CENTER
Active
Other names
Evergreen Cardiology Clinic, PS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS M ENOMOTO MD (PRESIDENT/OWNER)
(425) 882-4700
Entity
Organization
Contact information
Practice address
8301 161ST AVE NE, SUITE 302, REDMOND, WA 98052-3858
(800) 243-5854
(206) 824-9510
Mailing address
PO BOX 13684, SEATTLE, WA 98198-1010
(800) 243-5854
(206) 824-9510
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1086495
—
WA
Enumeration date
05/18/2006
Last updated
08/22/2020
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