Organization
NORTHWEST COMPREHENSIVE PAIN CONSULTANTS INC P S
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIAN ELAINE JOHNSTON MD (PRESIDENT)
(360) 336-0123
Entity
Organization
Contact information
Practice address
125 N 18TH ST, STE # B, MOUNT VERNON, WA 98273-3902
(360) 336-0123
(360) 336-0126
Mailing address
125 N 18TH ST, STE # B, MOUNT VERNON, WA 98273-3902
(360) 336-0123
(360) 336-0126
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD00035789
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1117589
—
WA
Enumeration date
07/10/2007
Last updated
04/13/2011
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