Active NPI
Washington Center for Pain Management LLC
- Pain Medicine (Anesthesiology) Physician
- Renton, WA
National Provider Identifier
1336539733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6229050010 | Other | WA | DME PTAN |
National Provider Directory
National Provider DirectoryNPI 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.