BERT GREEN, M.D., P.S.

Registered Agent Information

Name	Role	Address
DAVID E. LESHNER, PC	Registered Agent	800 BELLEVUE WAY NE #400, BELLEVUE, WA, 98004-0000, UNITED STATES

Key Officers & Management

Name	Role	Address
BERT GREEN MD	Governing Person	16259 SYLVESTER RD SW #404, BURIEN, WA, 98166, UNITED STATES

National Provider Identifier

Authorized Person:

Taxonomy:

Contacts:

Form 5500 Series