NPIMap

Organization Active NPI

Washington Center for Pain Management PLLC

  • Interventional Pain Medicine Physician
  • Everett, WA
National Provider Identifier
1992335541
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
WASHINGTON CENTER FOR PAIN MANAGEMENT PLLC
Practice address
3426 Broadway Ste 101
Everett, WA 98201-5098
Phone
(425) 774-1538
Fax
(888) 718-9625
NPI assigned
Jan 23, 2020
Organization subpart
Yes
Parent organization
WASHINGTON CENTER FOR PAIN MANAGEMENT PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Authorized official

Name
Phuong Nguyen
Title
Credentialing Specialist
Phone
(425) 774-1538

Specialties & licenses 1

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

Addresses

Primary practice location

3426 Broadway Ste 101
Everett, WA 98201-5098

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

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

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
Sports and Spine9 organizations share this tax ID, including this one
Part of
Sports and Spine

Other organizations with this tax ID 8

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1579737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579737600000",
    "number": "1992335541",
    "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": "3426 BROADWAY STE 101",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982015098",
            "telephone_number": "425-774-1538",
            "fax_number": "888-718-9625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON CENTER FOR PAIN MANAGEMENT PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WASHINGTON CENTER FOR PAIN MANAGEMENT PLLC",
        "enumeration_date": "2020-01-23",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "PHUONG",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "425-774-1538"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.