Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Collaborative Pain Management, PLLC

Organization Pain Medicine Physician · NPI 1356947295

Collaborative Pain Management, PLLC is a Pain Medicine Physician in Fairfax, Virginia. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

10400 Eaton Pl Ste 312
Fairfax, VA 22030-2208
Phone: (703) 261-6758
Fax: (703) 995-4860
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pain Medicine Physician (primary) Taxonomy 208VP0000X
Pain Clinic/Center Taxonomy 261QP3300X

Record details

NPI number1356947295
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michelle Jacques — Managing Member · (703) 261-6758
NPI enumeratedDecember 7, 2020
Last updated in NPPESDecember 7, 2020
Certification dateDecember 3, 2020
Mailing address10400 Eaton Pl Ste 312, Fairfax, VA 22030-2208

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