Provider Demographics
NPI:1184680498
Name:SOUND PAIN ALLIANCE
Entity Type:Organization
Organization Name:SOUND PAIN ALLIANCE
Other - Org Name:PENINSULA PAIN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:STUIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-752-0518
Mailing Address - Street 1:9220 RIDGETOP BLVD NW STE 200
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8556
Mailing Address - Country:US
Mailing Address - Phone:360-415-9110
Mailing Address - Fax:360-479-0265
Practice Address - Street 1:9220 RIDGETOP BLVD NW
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8556
Practice Address - Country:US
Practice Address - Phone:360-415-9110
Practice Address - Fax:360-479-0265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB32058Medicare PIN