NPIMap

Organization Active NPI

Sound Pain Alliance

Doing business as Puget Sound Pain Clinic

  • Pain Clinic/Center
  • Lakewood, WA
National Provider Identifier
1053431684
Registry record updated Jul 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
SOUND PAIN ALLIANCE
Doing business as
Puget Sound Pain Clinic
Practice address
11306 Bridgeport Way SW
#D
Lakewood, WA 98499-3037
Phone
(253) 983-9390
Fax
(253) 983-0066
NPI assigned
Mar 29, 2007
Last updated
Jul 22, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
PUGET SOUND PAIN CLINIC, P.S.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 22, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Erika Stuit
Title
Administrator
Phone
(360) 752-0518

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X OP00001595 WA
Clinic/Center 261Q00000X
Pain Clinic/Center 261QP3300X OP00001595 WA
Pain Clinic/Center 261QP3300X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

11306 Bridgeport Way SW
#D
Lakewood, WA 98499-3037

Mailing address

PO Box 39324
Lakewood, WA 98496-3324
Phone (253) 983-9390

Other names 1

  • Puget Sound Pain Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190913002678 WA DME Supplier - Physician - Osteopathic Manipulative Medicine 0941565162 Practice locations: Lakewood, WA

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Sound Pain Alliance26 organizations share this tax ID, including this one
Part of
Puget Sound Pain Clinic

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

11306 Bridgeport Way SW
Lakewood, WA 98499
Phone (253) 588-0370

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563753600000",
    "number": "1053431684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39324",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984963324",
            "telephone_number": "253-983-9390",
            "fax_number": "253-983-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11306 BRIDGEPORT WAY SW",
            "address_2": "#D",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993037",
            "telephone_number": "253-983-9390",
            "fax_number": "253-983-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUND PAIN ALLIANCE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PUGET SOUND PAIN CLINIC, P.S.",
        "enumeration_date": "2007-03-29",
        "last_updated": "2019-07-22",
        "status": "A",
        "authorized_official_last_name": "STUIT",
        "authorized_official_first_name": "ERIKA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "360-752-0518"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "WA",
            "license": "OP00001595",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "WA",
            "license": "OP00001595",
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Puget Sound Pain Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.