Organization Active NPI

Washington Center for Pain Management LLC

  • Pain Medicine (Anesthesiology) Physician
  • Renton, WA
National Provider Identifier
1336539733
Registry record updated Jun 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
WASHINGTON CENTER FOR PAIN MANAGEMENT LLC
Practice address
1412 SW 43Rd St
Suite 110
Renton, WA 98057-4803
Phone
(425) 774-1538
Fax
(425) 774-5171
NPI assigned
Jan 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2015

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

Authorized official

Name
Jae Lee
Title
Ceo
Phone
(425) 774-1538

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X WA Primary

Addresses

Primary practice location

1412 SW 43Rd St
Suite 110
Renton, WA 98057-4803

Mailing address

PO Box 827
Bellevue, WA 98009-0827
Phone (425) 774-1538

Other identifiers 1

IdentifierTypeStateIssuer
6229050010OtherWADME PTAN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433203200000",
    "number": "1336539733",
    "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",
            "fax_number": "425-774-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 SW 43RD ST",
            "address_2": "SUITE 110",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574803",
            "telephone_number": "425-774-1538",
            "fax_number": "425-774-5171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON CENTER FOR PAIN MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-23",
        "last_updated": "2015-06-02",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JAE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "425-774-1538"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME PTAN",
            "identifier": "6229050010",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.