Healthcare Provider Details

I. General information

NPI: 1225572381
Provider Name (Legal Business Name): ACUTE PAIN MANAGEMENT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2016
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13033 NE BEL RED RD STE 210
BELLEVUE WA
98005-2633
US

IV. Provider business mailing address

13033 NE BEL RED RD STE 210
BELLEVUE WA
98005-2633
US

V. Phone/Fax

Practice location:
  • Phone: 425-440-3351
  • Fax: 425-440-3439
Mailing address:
  • Phone: 425-440-3351
  • Fax: 425-440-3439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD60216841
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberMD60491842
License Number StateWA

VIII. Authorized Official

Name: KATIE DEHAAN
Title or Position: ADMIN
Credential:
Phone: 425-440-3351