# PACIFIC RIM HEADACHE CENTER

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

## Provider details

- **NPI number:** 1174822159
- **Authorized official:** JOHNNY MICHAEL JONES MPAS-C (OWNER)
- **Authorized official phone:** (360) 588-1460

## Contact information

- **Practice address:** 715 SEAFARERS WAY, STE 201 B, ANACORTES, WA 98221-2257
- **Practice address phone:** (360) 588-1460
- **Practice address fax:** (360) 588-1473
- **Mailing address:** 715 SEAFARERS WAY, STE 201 B, ANACORTES, WA 98221-2257
- **Mailing address phone:** (360) 588-1460
- **Mailing address fax:** (360) 588-1473

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 00009893 | WA | — |
| 207Q00000X | Family Medicine Physician | 00017410 | WA | — |
| 363A00000X | Physician Assistant | 10004470 | WA | Yes |

## Other

- **Enumeration date:** 03/16/2011
- **Last updated:** 03/01/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1174822159 | — | WA |