Organization
EVERGREEN EYE CENTER, PLLC
Active
Parent organization
EVERGREEN EYE CENTER, PLLC
Other names
Evergreen Eye Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
EVERGREEN EYE CENTER, PLLC
Authorized official
ROSA CAMPOS (CREDENTIALING MANAGER)
(206) 215-2004
Entity
Organization
Contact information
Practice address
502 S M ST, TACOMA, WA 98405-3728
(800) 340-3595
Mailing address
502 S M ST, TACOMA, WA 98405-3728
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
Other
Enumeration date
08/02/2019
Last updated
01/12/2024
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