| Evergreen Dermatology Center | |
|
1515 116th Ave Ne Suite 307 Bellevue WA 98004-3811 | |
| (425) 899-4300 | |
| (425) 688-8850 |
| Full Name | Evergreen Dermatology Center |
|---|---|
| Speciality | Clinic/center |
| Location | 1515 116th Ave Ne, Bellevue, Washington |
| Authorized Official Name and Position | Joanna B Sloan (OWNER) |
| Authorized Official Contact | 4258994300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Dermatology Center 1515 116th Ave Ne Suite 307 Bellevue WA 98004-3811 Ph: (425) 899-4300 | Evergreen Dermatology Center 1515 116th Ave Ne Suite 307 Bellevue WA 98004-3811 Ph: (425) 899-4300 |
| NPI Number | 1154400166 |
|---|---|
| Provider Enumeration Date | 11/02/2006 |
| Last Update Date | 07/27/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154400166 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | MD00029104 (Washington) | Primary |
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