Pacific Pain Specialists

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

MD 00047320 Issued in WA

Legal business name

PACIFIC PAIN SPECIALISTS

Practice address

22510 SE 64TH Place
Suite 120
Issaquan, WA 98027

Phone

(425) 391-2722

Fax

(425) 391-2922

NPI assigned

Nov 4, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Jason Kim, MDNPI 1265534036

Title

Owner/Manager

Phone

(206) 601-2097

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

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

• Jason Kim, MD

  • Pain Medicine (Anesthesiology) Physician
  • Issaquah, WA
  • NPI 1265534036
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1257292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285027200000",
    "number": "1205163771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22510 SE 64TH PLACE",
            "address_2": "SUITE 120",
            "city": "ISSAQUAN",
            "state": "WA",
            "postal_code": "98027",
            "telephone_number": "425-391-2722",
            "fax_number": "425-391-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22510 SE 64TH PLACE",
            "address_2": "SUITE 120",
            "city": "ISSAQUAN",
            "state": "WA",
            "postal_code": "98027",
            "telephone_number": "425-391-2722",
            "fax_number": "425-391-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC PAIN SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-04",
        "last_updated": "2010-09-21",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "206-601-2097",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "WA",
            "license": "MD 00047320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Reid Folkman, DDS

• Pain Medicine (Anesthesiology) Physician in Issaquan, WA
• Providers in Issaquan, WA by specialty
• Pain Medicine (Anesthesiology) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; 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.