NPI 1093763419
Evergreen at Polson, L.L.C.
Practice location
- Address
- 9 14th Ave W, Polson, MT 59860-5321
- Phone
- (406) 883-4378
- Fax
- (406) 883-3388
- Mailing address
- 4601 NE 77th Ave Suite 300, Vancouver, WA 98662-6736
Authorised official
- Name
- Brent Weil
- Title
- Ceo and Manager
- Phone
- (360) 892-6628
Registered specialties (4)
Skilled Nursing Facility
Primary
Occupational Therapist
Hearing and Speech Clinic/Center
Hearing and Speech Clinic/Center
Registry record
- NPI
- 1093763419
- Entity type
- Organization
- NPI issued
- 5 May 2006
- Record last updated
- 11 Mar 2021
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.