| Coastline Spine And Pain Center Llc | |
|
4626 Martin Luther King Jr Way S Seattle WA 98108-2135 | |
| (206) 721-8000 | |
| (979) 256-0818 |
| Full Name | Coastline Spine And Pain Center Llc |
|---|---|
| Speciality | Pain Medicine |
| Location | 4626 Martin Luther King Jr Way S, Seattle, Washington |
| Authorized Official Name and Position | Bao N Dinh (OWNER) |
| Authorized Official Contact | 2067218000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastline Spine And Pain Center Llc 4626 Martin Luther King Jr Way S Seattle WA 98108-2135 Ph: (206) 721-8000 | Coastline Spine And Pain Center Llc 4626 Martin Luther King Jr Way S Seattle WA 98108-2135 Ph: (206) 721-8000 |
| NPI Number | 1114792439 |
|---|---|
| Provider Enumeration Date | 11/16/2023 |
| Last Update Date | 11/16/2023 |
| Medicare PECOS PAC ID | 3779920715 |
|---|---|
| Medicare Enrollment ID | O20240326001705 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114792439 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | (* (Not Available)) | Primary |
| Provider Name | Bao N Dinh |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1881252229 PECOS PAC ID: 4688011620 Enrollment ID: I20240326001801 |
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