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
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
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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