NPIMap

Organization Active NPI

Washington Center for Pain Management LLC

  • Clinic/Center
  • Puyallup, WA
National Provider Identifier
1194381905
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
WASHINGTON CENTER FOR PAIN MANAGEMENT LLC
Practice address
120 14TH Ave SE Ste B
Puyallup, WA 98372-3718
Phone
(425) 774-1538
NPI assigned
May 16, 2019
Organization subpart
Yes
Parent organization
WASHINGTON CENTER FOR PAIN MANAGEMENT PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Authorized official

Name
Jacky Hong
Title
Office Manager
Phone
(425) 774-1538

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

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) 774-1538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070615000367 WA Part B Supplier - Clinic/Group Practice 0143329169 Receives reassigned benefits from 11 practitioners
10 other NPIs on this enrollment
Practice locations: Puyallup, WA; Bellevue, WA; Olympia, WA; Lacey, WA; Everett, WA; Edmonds, WA
O20191010002751 WA DME Supplier - Physician - Interventional Pain Management 0143329169 Practice locations: Puyallup, WA

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Sports and Spine

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575331200000",
    "number": "1194381905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 827",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980090827",
            "telephone_number": "425-774-1538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 14TH AVE SE STE B",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723718",
            "telephone_number": "425-774-1538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON CENTER FOR PAIN MANAGEMENT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WASHINGTON CENTER FOR PAIN MANAGEMENT PLLC",
        "enumeration_date": "2019-05-16",
        "last_updated": "2019-12-03",
        "status": "A",
        "authorized_official_last_name": "HONG",
        "authorized_official_first_name": "JACKY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "425-774-1538"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.