Organization
EVERGREEN VISION CORP.
Active
Other names
Evergreen Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE P.M NGO O.D (OPTOMETRIST)
(206) 329-5700
Entity
Organization
Contact information
Practice address
412 12TH AVE S, #205, SEATTLE, WA 98144-2032
(206) 329-5700
(206) 329-4894
Mailing address
412 12TH AVE S, #205, SEATTLE, WA 98144-2032
(206) 329-5700
(206) 329-4894
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2089
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2020337
—
WA
Enumeration date
07/03/2006
Last updated
08/22/2020
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