Provider Demographics
NPI:1659541035
Name:PEARSON AND WEARY PAIN RELIEF CLINICS P.C.
Entity Type:Organization
Organization Name:PEARSON AND WEARY PAIN RELIEF CLINICS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-927-8997
Mailing Address - Street 1:1410 NORTH MULLAN STE. 200
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4046
Mailing Address - Country:US
Mailing Address - Phone:509-927-8997
Mailing Address - Fax:509-927-3919
Practice Address - Street 1:1410 NORTH MULLAN STE. 200
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4046
Practice Address - Country:US
Practice Address - Phone:509-927-8997
Practice Address - Fax:509-927-3919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U23797Medicare UPIN
U84608Medicare UPIN
WAG8801709Medicare PIN
T02439Medicare UPIN
V00611Medicare UPIN