| Organization Name: | PACIFIC RIM HEADACHE CENTER |
| NPI Number: | 1174822159 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHNNY MICHAEL JONES (OWNER) |
| Mailing Address: | 715 Seafarers Way Ste 201 B Anacortes |
| State: | WA US |
| Postal Code: | 982212257 |
| Phone Number: | 3605881460 |
| Fax Number: | 3605881473 |
| NPI Enumeration Date: | 03/16/2011 |
| NPI Last Update Date: | 03/01/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 00009893 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |