Provider Demographics
NPI:1740627652
Name:SEATTLE PAIN CENTER MEDICAL CORPORATION
Entity type:Organization
Organization Name:SEATTLE PAIN CENTER MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
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 1:801 SW 16TH ST.
Mailing Address - Street 2:STE 121
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2628
Mailing Address - Country:US
Mailing Address - Phone:206-805-8885
Mailing Address - Fax:206-805-8886
Practice Address - Street 1:2950 LIMITED LN NW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-4577
Practice Address - Country:US
Practice Address - Phone:360-252-9777
Practice Address - Fax:360-252-9778
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEATTLE PAIN CENTER MEDICAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-31
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty