Organization
EVERGREEN SURGERY CENTER, LLC
Active
Other names
Evergreen Surgical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFF TOMLIN M.D. (EXECUTIVE DIRECTOR)
(425) 899-5656
Entity
Organization
Contact information
Practice address
12333 NE 130TH LN, SUITE 500, KIRKLAND, WA 98034-7467
(425) 899-5656
(425) 899-5638
Mailing address
12333 NE 130TH LN, SUITE 500, KIRKLAND, WA 98034-7467
(425) 899-5656
(425) 899-5638
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7123631
—
WA
Enumeration date
11/09/2005
Last updated
09/20/2007
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