Provider Demographics
NPI:1578864054
Name:NW PAIN INSTITUTE
Entity Type:Organization
Organization Name:NW PAIN INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WERNER
Authorized Official - Middle Name:
Authorized Official - Last Name:VON MARKSFELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-433-9580
Mailing Address - Street 1:16821 SE MCGILLIVRAY BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-0402
Mailing Address - Country:US
Mailing Address - Phone:360-433-9580
Mailing Address - Fax:
Practice Address - Street 1:16821 SE MCGILLIVRAY BLVD STE 204
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-0402
Practice Address - Country:US
Practice Address - Phone:360-433-9580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00033824111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty