NPIMap

Organization Active NPI

Washington Center for Pain Management, LLC

  • Interventional Pain Medicine Physician
  • Olympia, WA
National Provider Identifier
1871260760
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
WASHINGTON CENTER FOR PAIN MANAGEMENT, LLC
Practice address
3525 Ensign Rd NE Ste a
Olympia, WA 98506-5065
Phone
(425) 774-1538
Fax
(888) 718-9625
NPI assigned
Aug 27, 2021
Last updated
Aug 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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

Authorized official

Name
Jacky Hong
Title
Office Manager
Phone
(425) 774-1538

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X NU Primary

Addresses

Primary practice location

3525 Ensign Rd NE Ste a
Olympia, WA 98506-5065

Mailing address

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

Other names 1

  • Washington Center for Pain Management Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070615000367 WA Part B Supplier - Clinic/Group Practice 0143329169 Receives reassigned benefits from 11 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Puyallup, WA; Bellevue, WA; Olympia, WA; Lacey, WA; Everett, WA; Edmonds, WA
O20211213001399 WA DME Supplier - Physician - Interventional Pain Management 0143329169 Practice locations: Olympia, WA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Oregon Pain Center9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

14670 NE 8th St
Ste 105
Bellevue, WA 98007
Phone (425) 301-5816

3426 Broadway
Ste 101
Everett, WA 98201
Phone (425) 212-9286

155 Lilly Rd NE
Ste A
Olympia, WA 98506
Phone (206) 895-1825

1408 3rd St SE
Ste 100
Puyallup, WA 98372
Phone (206) 841-3979

1560 N 115th St
Ste 206
Seattle, WA 98133
Phone (206) 363-0103

Practitioners & affiliated clinicians

Practitioners 6

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": "1630022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630022400000",
    "number": "1871260760",
    "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": "888-718-9625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 ENSIGN RD NE STE A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065065",
            "telephone_number": "425-774-1538",
            "fax_number": "888-718-9625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON CENTER FOR PAIN MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-27",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-10",
        "status": "A",
        "authorized_official_last_name": "HONG",
        "authorized_official_first_name": "JACKY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "425-774-1538"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Washington Center for Pain Management",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; 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.