Organization
BERT GREEN, M.D., P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERT GREEN MD (OWNER)
(206) 241-1818
Entity
Organization
Contact information
Practice address
16259 SYLVESTER RD SW, SUITE 404, BURIEN, WA 98166-3049
(206) 241-1818
Mailing address
16259 SYLVESTER RD SW, SUITE 404, BURIEN, WA 98166-3049
(206) 592-5000
(206) 824-9510
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060036294
RR MEDICARE
WA
05
—
1890003
—
WA
Enumeration date
07/23/2006
Last updated
05/12/2014
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