Organization
PUBLIC HOSPITAL DISTRICT NO 2
Active
Parent organization
PUBLIC HOSPITAL DISTRICT NO 2
Other names
Evergreen Medical Group Woodinville
Organization subpart
Yes
Provider details
NPI number
Legal business name
PUBLIC HOSPITAL DISTRICT NO 2
Authorized official
ROBERT MALTE (CEO)
(425) 899-2610
Entity
Organization
Contact information
Practice address
17000 140TH AVE NE, STE 101, WOODINVILLE, WA 98072-6928
(425) 481-6363
(425) 488-4971
Mailing address
PO BOX 34036, SEATTLE, WA 98124-1036
(425) 899-3292
(425) 899-3269
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7072374
—
WA
01
—
CG2833
MEDICARE RAILROAD
WA
01
—
CG8137
MEDICARE RAILROAD
WA
01
—
CJ9678
MEDICARE RAILROAD
WA
01
—
CQ2437
MEDICARE RAILROAD
WA
Enumeration date
09/26/2006
Last updated
01/04/2011
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