Provider Demographics
NPI:1932309978
Name:PAIN MANAGEMENT FACILITY, LLC
Entity Type:Organization
Organization Name:PAIN MANAGEMENT FACILITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAVNIT
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-292-7005
Mailing Address - Street 1:9155 SW BARNES RD STE 934
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6636
Mailing Address - Country:US
Mailing Address - Phone:503-292-7005
Mailing Address - Fax:503-292-9058
Practice Address - Street 1:9155 SW BARNES RD STE 934
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6636
Practice Address - Country:US
Practice Address - Phone:503-292-7005
Practice Address - Fax:503-292-9058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty