Organization
EVERGREEN EYE CENTER, PLLC
Active
Other names
Evergreen Eye Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROSA ANGELICA CAMPOS (CREDENTIALING MANAGER)
(206) 215-2004
Entity
Organization
Contact information
Practice address
1229 MADISON ST STE 1250, SEATTLE, WA 98104-3568
(206) 212-2100
(206) 212-2194
Mailing address
1229 MADISON ST STE 1250, SEATTLE, WA 98104-3568
(206) 212-2100
(206) 212-2194
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
01/16/2018
Last updated
01/12/2024
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