Evergreen Dermatopathology Pllc
NPI #1700581170 in Liberty Lake, Washington
Provider Information
- NPI Number
- 1700581170
- Entity Type
- Organization
- Organization Name
- Evergreen Dermatopathology Pllc
- Primary Specialty
- Pathology - Dermatopathology
- Enumeration Date
- Apr 4, 2023
- Last Updated
- Apr 4, 2023
Practice Location
- Address
- 2110 N MOLTER RD #112
- City
- Liberty Lake
- State
- Washington
- ZIP Code
- 99019
- Phone
- (208) 277-9704
Authorized Official
- Name
- ASHLEY ANNE HAMSTRA, MD
- Title
- PRACTICE OWNER
- Phone
- (208) 277-9704
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pathology - Dermatopathology — Dermatopathology |
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