Healthcare Provider Details

I. General information

NPI: 1437497070
Provider Name (Legal Business Name): PAIN CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2013
Last Update Date: 01/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 212TH ST SW STE 212
EDMONDS WA
98026-7618
US

IV. Provider business mailing address

7500 212TH ST SW STE 212
EDMONDS WA
98026-7618
US

V. Phone/Fax

Practice location:
  • Phone: 425-744-6022
  • Fax:
Mailing address:
  • Phone: 425-744-6022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberOP00001058
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License NumberOP00001058
License Number StateWA

VIII. Authorized Official

Name: DR. TODD JOHN BAUMEISTER
Title or Position: PRESIDENT
Credential: D.O.
Phone: 425-744-6022