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General NPI Number Information
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NPI Number | 1235349051
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Entity Type | Organization
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Legal Business Name | EVAN H. HIRSCH, M.D., INC., P.S.
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 3525 ENSIGN RD NE SUITE N
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City | OLYMPIA
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State | WA
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Zip | 98506-5065
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Country | US
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Telephone | 360-464-9965
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Fax | 888-406-8040
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Provider Business Mailing Address
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Address Line | 3525 ENSIGN RD NE SUITE N
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City | OLYMPIA
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State | WA
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Zip | 98506-5065
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Country | US
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Telephone | 360-464-9965
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Fax | 888-406-8040
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EVAN H HIRSCH
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Credential | M.D.
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Telephone | 360-464-9965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | MD00046712
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License Number State | WA
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