Organization
EVERGREENHEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE SMITH MD (MEDICAL DIRECTOR)
(425) 899-6800
Entity
Organization
Contact information
Practice address
11521 NE 128TH ST, SUITE 100, KIRKLAND, WA 98034-4317
(425) 899-6797
(425) 899-6808
Mailing address
11521 NE 128TH ST, SUITE 100, KIRKLAND, WA 98034-4317
(425) 899-6797
(425) 899-6808
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
PH60004517
WA
Other
Enumeration date
04/14/2016
Last updated
04/14/2016
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