Organization
PACIFIC RIM HEADACHE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNNY MICHAEL JONES MPAS-C (OWNER)
(360) 588-1460
Entity
Organization
Contact information
Practice address
715 SEAFARERS WAY, STE 201 B, ANACORTES, WA 98221-2257
(360) 588-1460
(360) 588-1473
Mailing address
715 SEAFARERS WAY, STE 201 B, ANACORTES, WA 98221-2257
(360) 588-1460
(360) 588-1473
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
00009893
WA
207Q00000X
Family Medicine Physician
00017410
WA
363A00000X
Physician Assistant
Primary
10004470
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174822159
—
WA
Enumeration date
03/16/2011
Last updated
03/01/2012
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