Provider Demographics
NPI:1780135368
Name:PAIN CARE PHYSICIANS PLLC
Entity type:Organization
Organization Name:PAIN CARE PHYSICIANS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-538-6300
Mailing Address - Street 1:801 SW 16TH ST
Mailing Address - Street 2:SUITE 121
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2697
Mailing Address - Country:US
Mailing Address - Phone:206-538-6300
Mailing Address - Fax:206-538-6301
Practice Address - Street 1:3305 NASSAU ST STE B
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4140
Practice Address - Country:US
Practice Address - Phone:206-538-6300
Practice Address - Fax:206-538-6301
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAIN CARE PHYSICIANS PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-19
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
1144779232OtherBILLING GROUP NPI