PACIFIC PAIN SPECIALISTS (NPI# 1205163771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205163771 |
| Entity Type | Organization |
| Organization Name | PACIFIC PAIN SPECIALISTS |
| Practice Address |
22510 Se 64th Place Suite 120 Issaquan WA 98027 |
| Practice Telephone | 4253912722 |
| Practice Fax Number | 4253912922 |
| Mailing Telephone | 4253912722 |
| Mailing Fax Number | 4253912922 |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2010-09-21 |
| Authorized Official Name | DR. JASON KIM (OWNER/MANAGER) |
| Authorized Official Telephone | 2066012097 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
MD 00047320 | WA | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PACIFIC PAIN SPECIALISTS, PLLC | 1301 4th Ave Nw, Suite 200, Issaquah, WA 98027-9371 |
| Street Address |
22510 SE 64TH PLACE SUITE 120 |
| City | ISSAQUAN |
| State | WA |
| Zip Code | 98027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780281840 | Cascade Hand & Orthopedic Rehab, Inc. | Clinic/Center | 1301 4th Avenue Nw, Suite 200, Issaquah, WA 98027 | 2020-10-01 |
| 1700494630 | Genevieve S Ward | Counselor | 22500 Se 64th Place, Building G, Suite 150, Issaquah, WA 98027 | 2020-07-16 |
| 1891338604 | Amy Mezulis | Psychologist | 1740 Nw Maple St. #210, Issaquah, WA 98027 | 2019-10-24 |
| 1578055083 | Vivian Yu-en Hsiao | Physical Therapist | 1301 4th Ave Nw Ste 300, Issaquah, WA 98027 | 2018-05-31 |
| 1831698000 | Peter James Carlson | Physical Therapist | 22500 Se 64th Place, Building G, Suite 115, Issaquah, WA 98027 | 2018-02-02 |
| 1902323553 | David Robert Primrose | Dentist | 600 Nw Gilman Blvd Ste B, Issaquah, WA 98027 | 2017-08-24 |
| 1083135446 | Tara Rose | Massage Therapist | 680 Nw Gilman Blvd., Ste. A, Issaquah, WA 98027 | 2017-07-06 |
| 1295276194 | Amy Davenport | Occupational Therapist | 1871 Nw Gilman Blvd #2, Issaquah, WA 98027 | 2017-03-13 |
| 1942751771 | Krista L Gibbons | Counselor | 1700 Nw Blvd, Suite #200, Issaquah, WA 98027 | 2016-10-17 |
| 1376903237 | Kari Wathen Torres | Occupational Therapist | 710 Nw Juniper St Ste 100, Issaquah, WA 98027 | 2016-03-03 |
| Find all providers in zip 98027 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740822139 | Bellevue Pain and Wellness Pllc | Anesthesiology | 14550 Ne 29th Pl Ste 230, Bellevue, WA 98007-3630 | 2019-10-17 |
| 1659700730 | Washington Center for Pain Management LLC | Anesthesiology | 705 S 9th St Ste 102, Tacoma, WA 98405-4678 | 2013-11-08 |
| 1629332895 | North Cascade Pain Management Ps | Anesthesiology | 340 E George Hopper Rd, Suite #1, Burlington, WA 98233 | 2012-07-02 |
| 1396044947 | Mind Your Body Clinic Pllc | Anesthesiology | 6900 E Greenlake Way N, Suite J, Seattle, WA 98103 | 2011-03-22 |
| 1528228103 | Jared Paul Wagner | Anesthesiology | 636 Valley Mall Pkwy Ste 5, Wenatchee, WA 98802-4898 | 2008-06-17 |
| 1053585802 | Jordan Graham Graybill | Anesthesiology | 920 Ne 112th Ave Ste 104, Vancouver, WA 98684 | 2008-04-14 |
| 1780754499 | T Daniel Dibble Md PC | Anesthesiology | 1117 North Evergreen Rd, Suite 2, Spokane, WA 99216-1138 | 2006-11-09 |
| 1508936212 | Timothy Daniel Dibble | Anesthesiology | 1117 N Evergreen Rd Ste 2, Spokane Valley, WA 99216-1138 | 2006-11-09 |
| 1053499608 | Kathy I-wen Wang | Anesthesiology | 1519 3rd St Se Ste 101, Puyallup, WA 98372-3742 | 2006-11-01 |
| 1114017068 | Brendan Rhodes O'donnell | Anesthesiology | 21616 76th W Ave, Suite 209, Edmonds, WA 98026-7512 | 2006-10-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.