OrganizationActive
Coast Spine and Sports Medicine PLLC
NPI 1790401016 · Physical Medicine & Rehabilitation Physician · Lacey, WA
Provider details
- NPI number
- 1790401016
- Entity type
- Organization
- Primary specialty
- Physical Medicine & Rehabilitation PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Sandy Clemens, Access Manager(536) 481-8532
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
8140 Freedom Ln Ne Ste a
Lacey, WA 98516-4752
Phone: (253) 648-1853
Fax: (425) 800-9756
Approximate (ZIP-level) locationGet directions
Mailing address
8012 112th Street Ct E Ste 120
Puyallup, WA 98373-7856
Other names (DBA / former)
- Doing business as
- Coast Injury Medicine
Registry dates
- Enumerated
- 2022-10-18
- Last updated
- 2024-07-05
- Certified
- 2024-07-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.