Provider Demographics
NPI:1548520489
Name:SOUND INTERVENTIONAL PAIN MANAGEMENT, PLLC
Entity type:Organization
Organization Name:SOUND INTERVENTIONAL PAIN MANAGEMENT, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SULTANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-293-5453
Mailing Address - Street 1:PO BOX 2078
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98071-2078
Mailing Address - Country:US
Mailing Address - Phone:253-293-5453
Mailing Address - Fax:
Practice Address - Street 1:101 2ND ST NE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4902
Practice Address - Country:US
Practice Address - Phone:253-223-0515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-25
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical