NPIMap

Organization Active NPI

Pain Consultants of Washington, PLLC

  • Interventional Pain Medicine Physician
  • Kirkland, WA
National Provider Identifier
1437189818
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
MD00026916 Issued in WA
Legal business name
PAIN CONSULTANTS OF WASHINGTON, PLLC
Practice address
13123 121St Way NE
Suite D
Kirkland, WA 98034-3051
Phone
(425) 899-6030
Fax
(425) 899-6031
NPI assigned
Jul 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Authorized official

Name
Mrs. Bernadette M Nelson
Title
Operations Manager
Phone
(425) 899-6030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X MD00026916 WA Primary

Addresses

Primary practice location

13123 121St Way NE
Suite D
Kirkland, WA 98034-3051

Mailing address

13123 121St Way NE
Suite D
Kirkland, WA 98034-3051
Phone (425) 899-6030

Other identifiers 3

IdentifierTypeStateIssuer
5608570001OtherWAMEDICARE NORIDIAN ADMINIS
7125826MedicaidWA
0175948OtherWAL&I GROUP

National Provider Directory

National Provider Directory

Locations

13123 121st Way NE
#D
Kirkland, WA 98034
Phone (425) 899-6030

13125 121st Way NE
Kirkland, WA 98034
Phone (425) 899-6030

Practitioners & affiliated clinicians

Practitioners 4

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": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1437189818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13123 121ST WAY NE",
            "address_2": "SUITE D",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343051",
            "telephone_number": "425-899-6030",
            "fax_number": "425-899-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13123 121ST WAY NE",
            "address_2": "SUITE D",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343051",
            "telephone_number": "425-899-6030",
            "fax_number": "425-899-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CONSULTANTS OF WASHINGTON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2008-01-15",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "BERNADETTE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "425-899-6030",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "WA",
            "license": "MD00026916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NORIDIAN ADMINIS",
            "identifier": "5608570001",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7125826",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I GROUP",
            "identifier": "0175948",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; 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.