Provider Demographics
NPI:1912298290
Name:THE WASHINGTON CENTER FOR PAIN MANAGEMENT SLEEP LAB
Entity Type:Organization
Organization Name:THE WASHINGTON CENTER FOR PAIN MANAGEMENT SLEEP LAB
Other - Org Name:WCPM SLEEP LAB
Other - Org Type:Other Name
Authorized Official - Title/Position:CREDENTIALING & COMPLIANCE LIAISON
Authorized Official - Prefix:
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-774-1538
Mailing Address - Street 1:21616 76TH AVE W
Mailing Address - Street 2:#102
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-7512
Mailing Address - Country:US
Mailing Address - Phone:425-774-1538
Mailing Address - Fax:425-744-1527
Practice Address - Street 1:21616 76TH AVE W
Practice Address - Street 2:SUITE 102
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7512
Practice Address - Country:US
Practice Address - Phone:425-774-1538
Practice Address - Fax:425-744-1527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory