Healthcare Provider Details

I. General information

NPI: 1578833489
Provider Name (Legal Business Name): WASHINGTON CENTER FOR PAIN MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2012
Last Update Date: 11/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 116TH AVE NE SUITE 100
BELLEVUE WA
98004-3052
US

IV. Provider business mailing address

PO BOX 827
BELLEVUE WA
98009-0827
US

V. Phone/Fax

Practice location:
  • Phone: 425-774-1538
  • Fax: 425-774-5171
Mailing address:
  • Phone: 425-774-1538
  • Fax: 425-774-5171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. HYUN J HONG
Title or Position: OWNER/MEDICAL DIRECTOR
Credential: M.D.
Phone: 425-774-1538