PACIFIC NORTHWEST PAIN CENTER - NPI NUMBER 1114295300
Provider Name: PACIFIC NORTHWEST PAIN CENTER
NPI Number: 1114295300
Clasification: Anesthesiology (207LP2900X)
Specialization: Pain Medicine
2312 NE 129TH ST
Phone Number: (360) 696-5022
PACIFIC NORTHWEST PAIN CENTER is a pain medicine anesthesiologist in Vancouver, WA. The provider is an anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. The assigned NPI number for this provider is 1114295300 and is registered as an organization entity type and is a single specialty group.
The provider's business address is:
2312 NE 129TH ST
Phone: (360) 696-5022
Fax: (360) 696-5445
The provider's authorized official is Benjamin J Platt .
The authorized official title is President and has the following contact phone number (360) 696-5022.
The enumeration date for this NPI number is 12/2/2011 and was last updated on 12/2/2011.
Map - Location of Practice
||EUN JUNG YI, MD
Anesthesiology (Pain Medicine)
||DR. SAMMY JAMES HASSAN, M.D.
||DR. JAMES ALAN OBESTER, M.D.
||ANDREW OH, M.D.
||DR. NOOR AGHA MANSOORI, M.D.
The following information regarding the scope of practice of this provider is available:
||Entity Type Code
||Employer Identification Number EIN
||Provider Organization Name Legal Business Name
||PACIFIC NORTHWEST PAIN CENTER
||Provider First Line Business Practice Location Address
||2312 NE 129TH ST
||Provider Business Practice Location Address City Name
||Provider Business Practice Location Address State Name
||Provider Business Practice Location Address Postal Code
||Provider Business Practice Location Address Country Code If outside U S
||Provider Business Practice Location Address Telephone Number
||Provider Business Practice Location Address Fax Number
||Provider Enumeration Date
||Last Update Date
||Authorized Official Last Name
||Authorized Official First Name
||Authorized Official Middle Name
||Authorized Official Title or Position
||Authorized Official Telephone Number
||Healthcare Provider Taxonomy Code 1
||Provider License Number 1
||Provider License Number State Code 1
||Healthcare Provider Primary Taxonomy Switch 1
||Is Organization Subpart
||Authorized Official Name Prefix Text
||Authorized Official Credential Text
||Healthcare Provider Taxonomy Group 1
||193400000X SINGLE SPECIALTY GROUP
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This page was last updated on: 8/12/2014
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