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Organization

WASHINGTON PAIN AND SPINE SPECIALISTS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PRAVEEN KUMAR MAMBALAM MD (OWNER)
(240) 463-4101
Entity
Organization

Contact information

Practice address
3525 ENSIGN RD NE STE J, OLYMPIA, WA 98506-5065
(240) 463-4101
Mailing address
4957 LAKEMONT BLVD SE STE C-425, BELLEVUE, WA 98006-7801
(240) 463-4101

Taxonomy

Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary

Other

Enumeration date
07/31/2023
Last updated
07/31/2023
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