Provider Demographics
NPI:1780068528
Name:SEATTLE PAIN CENTER
Entity type:Organization
Organization Name:SEATTLE PAIN CENTER
Other - Org Name:
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 1:16821 SE MCGILLIVRAY BLVD
Practice Address - Street 2:STE 110
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-0499
Practice Address - Country:US
Practice Address - Phone:360-558-7990
Practice Address - Fax:360-558-7991
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEATTLE PAIN CENTER MEDICAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-10
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602811689207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty