Provider First Line Business Practice Location Address:
EVERGREEN HOSPITAL
Provider Second Line Business Practice Location Address:
12040 NE 128TH ST
Provider Business Practice Location Address City Name:
KIRKLAND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-583-6273
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/23/2011