Evergreen Radia LLC
Radiology, Diagnostic Radiology in Kirkland, WA. Organization (NPI-2).
NPI number1922095694
StatusActive
Last updated in NPPESSep 12, 2018
Details
- NPI
- 1922095694
- Entity type
- Organization (NPI-2)
- Legal business name
- Evergreen Radia LLC
- Organization subpart
- No
- Enumeration date
- Sep 28, 2005
- Last updated
- Sep 12, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0202X | Radiology, Diagnostic Radiology | 602317167 | WA | Yes |
Other names
- Evergreen Radia (Doing Business As)
Practice location
11521 Ne 128th StSuite 200
Kirkland, WA 98034-4317
Phone 425-952-6100 · Fax 425-952-6150
Mailing address
19020 33rd Ave W Ste 210Lynnwood, WA 98036-4748
Phone 425-563-1500 · Fax 425-563-1501
Authorized official
Lloyd Stambaugh
President
4255631500
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