- Enrollment id
- O20050318000074
- Enrollment state
- WA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1285719609
- Multiple npi flag
- N
- Ccn
- 501523
- Associate id
- 7618880097
- Organization name
- KING COUNTY PUBLIC HOSPITAL DISTRICT NO 2
- Doing business as name
- EVERGREENHEALTH HOSPICE CARE
- Incorporation date
- 1972-03-09
- Incorporation state
- WA
- Organization type structure
- OTHER
- Organization other type text
- MUNICIPAL CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 11800 NE 128TH ST #200
- City
- KIRKLAND
- State
- WA
- Zip code
- 980347211