Organization
ALPHA SPINE AND PAIN CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRAVEEN MAMBALAM (MD)
(425) 753-6705
Entity
Organization
Contact information
Practice address
3202 COLBY AVE STE B, EVERETT, WA 98201-4324
(425) 753-6705
Mailing address
PO BOX 827, BELLEVUE, WA 98009-0827
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
03/19/2021
Last updated
02/07/2023
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