Individual
BERT GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16259 SYLVESTER RD SW, STE 404, BURIEN, WA 98166-3049
(206) 248-0800
Mailing address
16259 SYLVESTER RD SW, SUITE 404, BURIEN, WA 98166-3049
(206) 248-0800
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD00016483
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060036294
RR MEDICARE
WA
05
—
1890003
—
WA
Enumeration date
10/18/2005
Last updated
05/12/2014
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