OrganizationActive
Collaborative Pain Management, PLLC
NPI 1356947295 · Pain Medicine Physician · Fairfax, VA
Provider details
- NPI number
- 1356947295
- Entity type
- Organization
- Primary specialty
- Pain Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Michelle Jacques, Managing Member(703) 261-6758
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Pain Clinic/Center261QP3300X
Ambulatory Health Care Facilities
Practice location
10400 Eaton Pl Ste 312
Fairfax, VA 22030-2208
Phone: (703) 261-6758
Fax: (703) 995-4860
Approximate (ZIP-level) locationGet directions
Mailing address
10400 Eaton Pl Ste 312
Fairfax, VA 22030-2208
Registry dates
- Enumerated
- 2020-12-07
- Last updated
- 2020-12-07
- Certified
- 2020-12-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.