Provider Demographics
NPI:1225369341
Name:WASHINGTON ADVANCED PAIN ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:WASHINGTON ADVANCED PAIN ASSOCIATES, PLLC
Other - Org Name:WAPA, ADVANCED PAIN CLINICS
Other - Org Type:Other Name
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:AYSEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ATLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-446-2465
Mailing Address - Street 1:5838 E GREEN LAKE WAY N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-5751
Mailing Address - Country:US
Mailing Address - Phone:206-446-2465
Mailing Address - Fax:
Practice Address - Street 1:3226 NASSAU ST
Practice Address - Street 2:SUITE A
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4139
Practice Address - Country:US
Practice Address - Phone:206-446-2465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA41983208100000X, 208VP0000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty