WASHINGTON CENTER FOR PAIN MANAGEMENT LLC (NPI# 1295145019) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295145019 |
| Entity Type | Organization |
| Organization Name | WASHINGTON CENTER FOR PAIN MANAGEMENT LLC |
| Practice Address |
13126 120th Ave Ne Kirkland WA 98034-3014 |
| Mailing Address |
Po Box 827 Bellevue WA 98009-0827 |
| Practice Telephone | 4257741538 |
| Practice Fax Number | 4257745171 |
| Mailing Telephone | 4257741538 |
| Mailing Fax Number | 4257745171 |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2017-05-02 |
| Authorized Official Name | MR. JAE LEE (CEO) |
| Authorized Official Telephone | 4257741538 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | DME PTAN | 6229050009 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194381905 | Washington Center for Pain Management LLC | Clinic/Center | 120 14th Ave Se Ste B, Puyallup, WA 98372-3718 | 2019-05-16 |
| 1659700730 | Washington Center for Pain Management LLC | Anesthesiology | 705 S 9th St Ste 102, Tacoma, WA 98405-4678 | 2013-11-08 |
| 1508473281 | Washington Center for Pain Management LLC | Pain Medicine | 2820 Northup Way Ste 245, Bellevue, WA 98004-1419 | 2020-09-28 |
| 1467846162 | Washington Center for Pain Management LLC | Anesthesiology | 922 S 348th St, Federal Way, WA 98003-7021 | 2015-03-20 |
| 1558751958 | Washington Center for Pain Management LLC | Anesthesiology | 11786 Sw Barnes Rd, Suite 270, Portland, OR 97225-5929 | 2015-01-23 |
| 1336539733 | Washington Center for Pain Management LLC | Anesthesiology | 1412 Sw 43rd St, Suite 110, Renton, WA 98057-4803 | 2015-01-23 |
| 1588067896 | Washington Center for Pain Management LLC | Anesthesiology | 1408 3rd St Se, 1st Floor, Puyallup, WA 98372-3702 | 2014-09-30 |
| 1215350814 | Washington Center for Pain Management LLC | Anesthesiology | 3305 Nassau St, Everett, WA 98201-4140 | 2014-02-03 |
| 1710300728 | Washington Center for Pain Management LLC | Anesthesiology | 1301 4th Ave Nw Ste 200, Issaquah, WA 98027-9371 | 2014-01-27 |
| 1124463864 | Washington Center for Pain Management LLC | Pain Medicine | 6323 111th St Sw, Lakewood, WA 98499-1303 | 2013-05-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | WASHINGTON CENTER FOR PAIN MANAGEMENT LLC | 12100 Northup Way, Bellevue, WA 98005 |
| Street Address |
13126 120TH AVE NE |
| City | KIRKLAND |
| State | WA |
| Zip Code | 98034-3014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497976179 | Troy W Thomas | Dentist | 13126 120th Ave Ne, Kirkland, WA 98034 | 2007-05-01 |
| 1558776963 | Marna Reams | Dental Hygienist | 13126 120th Ave Ne, Kirkland, WA 98034-3014 | 2014-06-24 |
| 1023311065 | Erin Reed | Dentist | 13126 120th Ave Ne, Kirkland, WA 98034-3014 | 2010-12-14 |
| 1689904054 | Whole Life Medicine Ps | Clinic/Center | 13126 120th Ave Ne, Kirkland, WA 98034-3014 | 2010-01-07 |
| 1326249723 | Tutland Thomas | Dentist | 13126 120th Ave Ne, Kirkland, WA 98034-3014 | 2007-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578116596 | Rachel Bowers | Behavior Technician | 1335 Northeast 122nd Way, Suite 105, Kirkland, WA 98034 | 2019-07-18 |
| 1740841048 | Kristina Louise Inghram | Behavior Technician | 11415 Ne 128th St., Suite 40, Kirkland, WA 98034 | 2019-06-26 |
| 1053978064 | Matthew A. Bagnulo, Dds, Ps | Dentist | 11830 Ne 128th St., #202, Kirkland, WA 98034 | 2019-05-24 |
| 1629568928 | Stephanie Michalko | Optometrist | 11800 Ne 128th St Ste 110, Kirkland, WA 98034 | 2018-05-14 |
| 1952800013 | Heath Family Counseling LLC | Marriage & Family Therapist | 12025 115th Ave. Ne, Building D, Ste 200, Kirkland, WA 98034 | 2018-02-05 |
| 1891202834 | Barbara Josephine Gorham | Counselor | 2025 115th Ave Ne, Bldg D, #200, Kirkland, WA 98034 | 2017-12-29 |
| 1548782915 | Eleanor Hollis Wall | Counselor | 14340 102nd Ave Ne, Kirkland, WA 98034 | 2017-07-07 |
| 1457885212 | Peter Schoonmaker | Hospitalist | 12040 Ne 128th Street, Ms105, Kirkland, WA 98034 | 2017-04-18 |
| 1780124370 | Rebecca Managan | Advanced Practice Midwife | 12303 Ne 130th Ln Ste Coral225, Kirkland, WA 98034 | 2017-03-01 |
| 1669821104 | Winter Gonzalez | Counselor | 11720 97th Ln Ne Apt A411, Kirkland, WA 98034 | 2016-06-06 |
| Find all providers in zip 98034 | ||||
| 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 |
|---|---|---|---|---|
| 1205878469 | Daniel Eric Nelson | Anesthesiology | 12911 120th Ave Ne, Suite H-210, Kirkland, WA 98034-3027 | 2006-06-12 |
| 1942254990 | Donald L Zimmermann | Anesthesiology | 12040 Ne 128th St, Kirkland, WA 98034-3013 | 2006-05-22 |
| 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 |
| 1205163771 | Pacific Pain Specialists | Anesthesiology | 22510 Se 64th Place, Suite 120, Issaquan, WA 98027 | 2009-11-04 |
| 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 |
| 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.