Organization
EVERGREEN NEUROLOGY CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND PARK MD (OWNER)
(425) 822-1214
Entity
Organization
Contact information
Practice address
12303 NE 130TH LN, SUITE 325, KIRKLAND, WA 98034-3099
(425) 822-1214
Mailing address
PO BOX 69737, SEATTLE, WA 98168-8737
(206) 431-0138
(206) 246-5819
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
WA
Other
Enumeration date
09/26/2007
Last updated
02/29/2008
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