| NPI | 1871032193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRAVEEN MAMBALAM Physician 425-563-6274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2017-02-20 |