Healthcare Provider Details

I. General information

NPI: 1184426892
Provider Name (Legal Business Name): MVP PHYSIATRY AND PAIN CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 S VASSAULT ST
TACOMA WA
98465-2008
US

IV. Provider business mailing address

PO BOX 66657
SEATTLE WA
98166-0657
US

V. Phone/Fax

Practice location:
  • Phone: 253-444-3320
  • Fax:
Mailing address:
  • Phone: 206-453-1818
  • Fax: 855-511-5091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: ALAN VO
Title or Position: OWNER
Credential: DO
Phone: 206-351-8141