| NPI | 1649776394 |
|---|---|
| Doing Business As | PENINSULA PAIN CLINIC |
| Doing Business As | MT BAKER PAIN CLINIC |
| Doing Business As | BLACK STONE HEALTH |
| Doing Business As | SOUND PAIN ALLIANCE LAB |
| Doing Business As | NORTHWEST PAIN SPECIALISTS |
| Doing Business As | PUGET SOUND PAIN CLINIC |
| Doing Business As | BONNEY LAKE MEDICAL |
| Entity Type | Organization |
| Authorized Contact | JOSH LEDER Administrator 801-641-5613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 291U00000X Clinical Medical Laboratory | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| 225100000X Physical Therapist | |
| 261Q00000X Clinic/Center | |
| 261QA1903X Clinic/Center, Ambulatory Surgical | |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2025-07-18 |