# NORTHWEST COAST INJURY MKEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093685703
- **Authorized official:** SANDY CLEMENS (ACCESS MANAGER)
- **Authorized official phone:** (253) 648-1853

## Contact information

- **Practice address:** 7720 NE VANCOUVER MALL DR STE 120, VANCOUVER, WA 98662-7918
- **Practice address phone:** (360) 524-4800
- **Practice address fax:** (425) 800-9756
- **Mailing address:** 8012 112TH STREET CT E STE 120, PUYALLUP, WA 98373-7856
- **Mailing address phone:** (253) 648-1853
- **Mailing address fax:** (425) 800-9756

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/07/2025
- **Last updated:** 11/07/2025