Alpha Spine and Pain Clinic PLLC
Organization Active NPI Interventional Pain Medicine Physician · Puyallup, WA
NPI 1033815352 · NPPES record last updated Feb 7, 2023
Key facts
- NPI
- 1033815352
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Interventional Pain Medicine Physician 208VP0014X
- Legal business name
- ALPHA SPINE AND PAIN CLINIC PLLC
- Practice address
- 120 14TH Ave SE Ste B
Puyallup, WA 98372-3718 - Phone
- (425) 777-4710
- Fax
- (888) 830-1615
- NPI assigned
- Feb 7, 2023
- Organization subpart
- No
Authorized official
- Name
- Praveen Kumar Mambalam
- Title
- MD
- Phone
- (425) 774-1538
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- Alpha Spine and Pain Clinic PLLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Interventional Pain Medicine Physician |
208VP0014X | Yes |
Addresses
Primary practice location
120 14TH Ave SE Ste B
Puyallup, WA 98372-3718
Mailing address
PO Box 827
Bellevue, WA 98009-0827
Phone (425) 777-1538
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All providers in Puyallup, WA · Interventional Pain Medicine Physician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.