Healthcare Provider Details

I. General information

NPI: 1902184724
Provider Name (Legal Business Name): WASHINGTON CENTER FOR PAIN MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2011
Last Update Date: 06/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3305 NASSAU ST
EVERETT WA
98201-4140
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 Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

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