Organization
EVERGREEN EMERGENCY SERVICES, PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD CRYSTAL MD (PRESIDENT)
(425) 899-1751
Entity
Organization
Contact information
Practice address
12040 NE 128TH ST, KIRKLAND, WA 98034-3013
(206) 550-5253
Mailing address
FILE 50421, LOS ANGELES, CA 90074-0001
(855) 691-9890
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
184567
WASHINGTON CRIME VICTIMS
—
01
—
604658700
US DEPTARMENT OF LABOR
—
05
—
7122864
—
WA
01
—
8938298
WASHINGTON CRIME VICTIMS
—
Enumeration date
06/17/2006
Last updated
11/20/2020
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