Organization
EVERGREEN CORPORATION
Active
Other names
Lakeshore Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OLEG ORDINARTSEV (MANAGER)
(425) 803-6800
Entity
Organization
Contact information
Practice address
134 CENTRAL WAY, KIRKLAND, WA 98033-6106
(425) 803-6800
(425) 803-6811
Mailing address
134 CENTRAL WAY, KIRKLAND, WA 98033-6106
(425) 803-6800
(425) 803-6811
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
CF58547
WA
Other
Enumeration date
02/22/2006
Last updated
08/22/2020
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