EVERGREEN ORAL SURGERY; NPI #1811586761

Contact Information

EVERGREEN ORAL SURGERY

6050 TACOMA MALL BLVD STE 330
TACOMA, WA 98409-6811

Phone: 253-473-0651
Fax: 253-444-0761
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Oral & Maxillofacial Surgery	204E00000X	02	Physician/General Surgery

Indicates primary specialty

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NPI Profile & details for EVERGREEN ORAL SURGERY

NPI Number	`1811586761`
LBN Legal business name	EVERGREEN ORAL SURGERY
Authorized official	ANGIE MINKS - (CREDENTIALING SPECIALIST)
Entity	Organization
Organization subpart ¹	No
Enumeration date	01/14/2021
Last updated	01/14/2021 - About 5 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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EVERGREEN ORAL SURGERY

Contact Information

Specialty

Oral & Maxillofacial Surgery

NPI Profile & details for EVERGREEN ORAL SURGERY

Reviews for EVERGREEN ORAL SURGERY