| NPI | 1871373894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN BRIAN MOON Contracting Coordinator 206-538-6300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2023-10-05 |
| Last Update Date | 2023-10-05 |