Provider Demographics
NPI:1497918536
Name:NW PAIN MANAGEMENT AND REHABILITATION ASSOCIATES, INC
Entity Type:Organization
Organization Name:NW PAIN MANAGEMENT AND REHABILITATION ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-518-6081
Mailing Address - Street 1:DEPT 1008
Mailing Address - Street 2:PO BOX 34936
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124
Mailing Address - Country:US
Mailing Address - Phone:206-439-2988
Mailing Address - Fax:206-431-3939
Practice Address - Street 1:16110 8TH AVE SW
Practice Address - Street 2:SUITE B-1A
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2962
Practice Address - Country:US
Practice Address - Phone:206-518-6081
Practice Address - Fax:206-518-6084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-09
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00039410208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty