Organization
EVERGREEN OPTICAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JEANNE MARIE MILLER (OFFICE MANAGER)
(509) 662-4747
Entity
Organization
Contact information
Practice address
351 ORONDO AVE, WENATCHEE, WA 98801-2826
(509) 662-4747
(509) 663-5338
Mailing address
351 ORONDO AVE, WENATCHEE, WA 98801-2826
(509) 662-4747
(509) 663-5338
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO 00000833
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000288
—
WA
Enumeration date
03/13/2015
Last updated
03/13/2015
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