Provider Demographics
NPI:1619287281
Name:PUBLIC HOSPITAL DISTRICT NO. 2
Entity Type:Organization
Organization Name:PUBLIC HOSPITAL DISTRICT NO. 2
Other - Org Name:EVERGREENHEALTH HEART & VASCULAR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISSY
Authorized Official - Middle Name:
Authorized Official - Last Name:YAMADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-899-1000
Mailing Address - Street 1:12333 NE 130TH LANE
Mailing Address - Street 2:#320
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034
Mailing Address - Country:US
Mailing Address - Phone:425-899-0555
Mailing Address - Fax:
Practice Address - Street 1:12333 NE 130TH LANE
Practice Address - Street 2:#320
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034
Practice Address - Country:US
Practice Address - Phone:425-899-0555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8863266Medicare PIN