# PACIFIC COAST INTEGRATED MEDICAL GROUP PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bellevue Pain Institute
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578151742
- **Authorized official:** DR. KEVIN LARRY POLZIN DC (MEMBER)
- **Authorized official phone:** (425) 922-2055

## Contact information

- **Practice address:** 12360 NE 8TH ST STE 200, BELLEVUE, WA 98005-4801
- **Practice address phone:** (425) 922-2055
- **Practice address fax:** (888) 899-4360
- **Mailing address:** 12360 NE 8TH ST STE 200, BELLEVUE, WA 98005-4801
- **Mailing address phone:** (425) 922-2055
- **Mailing address fax:** (888) 899-4360

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NN0400X | Neurology Chiropractor | — | NULL | — |
| 111NN0400X | Neurology Chiropractor | — | — | — |
| 111NX0800X | Orthopedic Chiropractor | — | NULL | — |
| 111NX0800X | Orthopedic Chiropractor | — | — | — |
| 175F00000X | Naturopath | — | NULL | Yes |
| 175F00000X | Naturopath | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 01/04/2021
- **Last updated:** 01/04/2021