Organization
PUBLIC HOSPITAL DISTRICT NO 2
Active
Parent organization
PUBLIC HOSPITAL DISTRICT NO 2
Other names
Evergreen Medical Group Sammamish
Organization subpart
Yes
Provider details
NPI number
Legal business name
PUBLIC HOSPITAL DISTRICT NO 2
Authorized official
ROBERT MALTE (CEO)
(425) 899-2610
Entity
Organization
Contact information
Practice address
22850 NE 8TH ST, STE 103, SAMMAMISH, WA 98074-7256
(425) 898-0305
(425) 898-8825
Mailing address
PO BOX 34036, SEATTLE, WA 98124-1036
(425) 899-3292
(425) 899-3269
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7099849
—
WA
01
—
CG2833
MEDICARE RAILROAD
WA
01
—
CG8137
MEDICARE RAILROAD
WA
01
—
CJ9678
MEDICARE RAILROAD
WA
01
—
CQ2437
MEDICARE RAILROAD
WA
Enumeration date
09/26/2006
Last updated
01/04/2011
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