NPIMap

Organization Active NPI

Sound Pain Alliance

Doing business as Bonney Lake Medical

  • Family Medicine Physician
  • Bonney Lake, WA
National Provider Identifier
1780429167
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SOUND PAIN ALLIANCE
Doing business as
Bonney Lake Medical
Practice address
21509 State Route 410 E Ste 1a
Bonney Lake, WA 98391-4104
Phone
(253) 891-2160
Fax
(253) 981-2171
NPI assigned
Jun 27, 2024
Last updated
Jun 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Clinic/Center 261Q00000X
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

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

Mailing address

4029 Northwest Ave Ste 301
Bellingham, WA 98226-9077

Other names 1

  • Bonney Lake Medical Doing business as

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

4029 Northwest Ave
Ste 301
Bellingham, WA 98226
Phone (360) 526-8685

NPI Registry JSON

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1780429167",
    "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 STE 1A",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983914104",
            "telephone_number": "253-891-2160",
            "fax_number": "253-981-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUND PAIN ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "LEDER",
        "authorized_official_first_name": "JOSH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-641-5613"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bonney Lake Medical",
            "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 Jun 27, 2024; 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.