Organization
PAIN CARE PHYSICIANS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN MOON (DIRECTOR OF REVENUE AND FINANCE)
(206) 538-6300
Entity
Organization
Contact information
Practice address
1415 N HOUK RD STE C, SPOKANE VALLEY, WA 99216-1043
(206) 538-6300
(206) 638-6301
Mailing address
801 SW 16TH ST, STE. 121, RENTON, WA 98057-2697
(206) 538-6300
(206) 538-6301
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
604032151
WA
208VP0014X
Interventional Pain Medicine Physician
Primary
604032151
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144779232
BILLING GROUP NPI
—
Enumeration date
10/13/2016
Last updated
07/21/2025
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