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Organization
PAIN CARE PHYSICIANS PLLC
Active
Organization
PAIN CARE PHYSICIANS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN MOON MD (DIRECTOR OF REVENUE AND FINANCE)
(206) 538-6300
Entity
Organization
Contact information
Practice address
1415 N HOUK RD STE B, SPOKANE VALLEY, WA 99216-1043
(206) 538-6300
(206) 538-6301
Mailing address
801 SW 16TH ST STE 121, RENTON, WA 98057-2628
(206) 538-6300
(206) 538-6301
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
—
NULL
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144779232
OTHER (NON-MEDICARE)
WA
01
—
50C0001354
MEDICARE CERTIFICATION NUMBER
WA
Enumeration date
06/10/2024
Last updated
07/21/2025
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