NPIMap

Organization Active NPI

Sound Pain Alliance

Doing business as Puget Sound Pain Clinic

  • Pain Clinic/Center
  • Bonney Lake, WA
National Provider Identifier
1306411277
Registry record updated May 5, 2023
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
21509 State Route 410 E # 1
Bonney Lake, WA 98391-4104
Phone
(253) 983-9390
Fax
(253) 983-0066
NPI assigned
May 24, 2021
Last updated
May 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2023

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

Authorized official

Name
Josh Leder
Title
Administrator
Phone
(801) 641-5613

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Clinic/Center 261Q00000X
Pain Clinic/Center 261QP3300X Primary

Addresses

Primary practice location

21509 State Route 410 E # 1
Bonney Lake, WA 98391-4104

Mailing address

4029 Northwest Ave Ste 301
Bellingham, WA 98226-9077

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
O20230922003273 WA DME Supplier - Multi-Specialty - Physician 0941565162 Practice locations: Bonney Lake, 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

Other organizations with this tax ID 25

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

View all 25

Locations

18401 Veterans Memorial Dr E
Bonney Lake, WA 98391
Phone (253) 826-5556

21509 State Route 410 E
#1
Bonney Lake, WA 98391

8804 Main St E
Bonney Lake, WA 98391
Phone (206) 833-6241

Practitioners & affiliated clinicians

Practitioners 5

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": "1621814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683244800000",
    "number": "1306411277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4029 NORTHWEST AVE STE 301",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21509 STATE ROUTE 410 E # 1",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983914104",
            "telephone_number": "253-983-9390",
            "fax_number": "253-983-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUND PAIN ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-24",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A",
        "authorized_official_last_name": "LEDER",
        "authorized_official_first_name": "JOSH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "801-641-5613"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Puget Sound Pain Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Puget Sound Pain Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bonney Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; 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.