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PACIFIC RIM HEADACHE CENTER NPI 1174822159


NPI Information

NPI: 1174822159
Provider Name: PACIFIC RIM HEADACHE CENTER
Classification: Physician Assistant - 363A00000X
Entity Type: Organization
Address:
715 SEAFARERS WAY
STE 201 B
ANACORTES, WA
ZIP 98221
Phone: (360) 588-1460
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PACIFIC RIM HEADACHE CENTER is a physician assistant in Anacortes, WA. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. PACIFIC RIM HEADACHE CENTER NPI is 1174822159. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

715 SEAFARERS WAY
STE 201 B
ANACORTES, WA
ZIP 98221-257
Phone: (360) 588-1460
Fax: (360) 588-1473

The provider's authorized official is Johnny Michael Jones .
The authorized official title is Owner and has the following contact phone number (360) 588-1460.

The enumeration date for this NPI number is 3/16/2011 and was last updated on 3/1/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YM0800XCounselorMental Health00009893WASHINGTONNo
2207Q00000XFamily Medicine00017410WASHINGTONNo
3363A00000XPhysician Assistant10004470WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11174822159MEDICAIDWASHINGTON
2G8900702MEDICARE UPINWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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