Organization
A WOMENS CLINIC AT EVERGREEN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN MARIE WATANABE (BILLING REPRESENTATIVE)
(425) 285-2145
Entity
Organization
Contact information
Practice address
12303 NE 130TH LN, SUITE 230, KIRKLAND, WA 98034-3099
(425) 899-3888
Mailing address
12303 NE 130TH LN, SUITE 230, KIRKLAND, WA 98034-3099
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7110588
DSHS NUMBER
WA
Enumeration date
11/14/2006
Last updated
04/11/2011
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