Provider Demographics
NPI:1619304714
Name:SEATTLE PAIN CENTER
Entity Type:Organization
Organization Name:SEATTLE PAIN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PAIN MANAGEMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-805-8885
Mailing Address - Street 1:3624 COLBY AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-4776
Mailing Address - Country:US
Mailing Address - Phone:425-250-5551
Mailing Address - Fax:
Practice Address - Street 1:3624 COLBY AVE
Practice Address - Street 2:SUITE B
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4776
Practice Address - Country:US
Practice Address - Phone:425-250-5551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60417676174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty