Organization
EVERGREEN NEUROLOGY & NEURODIAGNOSTIC PLLC
Active
Parent organization
ROMAN L KUTSY
Organization subpart
Yes
Provider details
NPI number
Legal business name
ROMAN L KUTSY
Authorized official
MRS. CHARIS J YATES (BILLING)
(425) 259-5121
Entity
Organization
Contact information
Practice address
2326 RUCKER AVE, EVERETT, WA 98201-2723
(425) 259-5121
(425) 252-2189
Mailing address
2320 RUCKER AVE, EVERETT, WA 98201-2723
(425) 259-5121
(425) 252-2189
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
MD00032822
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1118462
—
WA
Enumeration date
11/21/2007
Last updated
11/21/2007
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