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General NPI Number Information
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NPI Number | 1346657293
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Entity Type | Organization
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Legal Business Name | SEATTLE PAIN CENTER MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/11/2014
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Last Update Date | 05/19/2016
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Provider Practice Location Address
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Address Line | 20696 BOND RD NE BLDG C-205
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City | POULSBO
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State | WA
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Zip | 98370-9025
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Country | US
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Telephone | 360-930-3100
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Fax | 360-633-3137
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Provider Business Mailing Address
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Address Line | 801 SW 16TH ST. STE. 121
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City | RENTON
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State | WA
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Zip | 98057-2628
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Country | US
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Telephone | 206-805-8885
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Fax | 206-805-8886
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Authorized Official
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Title or Position | CEO/OWNER
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Name | FRANK LI
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Credential | MD
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Telephone | 206-805-8885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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