Organization
ALPHA SPINE AND PAIN CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRAVEEN KUMAR MAMBALAM (MD)
(425) 774-1538
Entity
Organization
Contact information
Practice address
120 14TH AVE SE STE B, PUYALLUP, WA 98372-3718
(425) 777-4710
(888) 830-1615
Mailing address
PO BOX 827, BELLEVUE, WA 98009-0827
(425) 777-1538
(888) 830-1615
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
02/07/2023
Last updated
02/07/2023
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