PROFESSIONAL RECREATION ORGANIZATION, INC. (NPI# 1235575861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235575861 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL RECREATION ORGANIZATION, INC. |
| Other Organization Name | PRO SPORTS CLUB |
| Practice Address |
4455 148th Ave Ne Bellevue WA 98007-3120 |
| Practice Telephone | 4258694746 |
| Practice Fax Number | 4258695285 |
| Mailing Telephone | 4258694746 |
| Mailing Fax Number | 4258695285 |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2017-08-07 |
| Authorized Official Name | MS. DEBBIE BECKER (SR DIRECTOR OF ACCOUNTING) |
| Authorized Official Telephone | 4258694746 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 600541508 | WA | Behavioral Health & Social Service Providers |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
600541508 | WA | Allopathic & Osteopathic Physicians |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
600541508 | WA | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| PRO Sports Club | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982238465 | Professional Recreation Organization, Inc. | Clinic/Center | 4455 148th Ave Ne, Bellevue, WA 98007-3120 | 2020-02-24 |
| 1144708819 | Professional Recreation Organization, Inc. | Clinic/Center | 4455 148th Ave Ne, Bellevue, WA 98007-3120 | 2018-08-03 |
| 1245726538 | Professional Recreation Organization, Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4455 148th Ave Ne, Bellevue, WA 98007-3120 | 2018-07-10 |
| 1508352881 | Professional Recreation Organization, Inc. | Obstetrics & Gynecology | 4455 148th Ave Ne, Bellevue, WA 98007-3120 | 2018-07-10 |
| 1861918518 | Professional Recreation Organization, Inc. | General Practice | 4455 148th Ave Ne, Bellevue, WA 98007-3120 | 2017-08-15 |
| 1780100438 | Professional Recreation Organization, Inc. | Clinic/Center | 4455 148th Ave Ne, Bellevue, WA 98007-3120 | 2017-08-15 |
| 1689194359 | Professional Recreation Organization, Inc. | Acupuncturist | 4455 148th Ave Ne, Bellevue, WA 98007-3120 | 2017-06-23 |
| 1063959427 | Professional Recreation Organization, Inc. | Naturopath | 4455 148th Ave Ne, Bellevue, WA 98007-3120 | 2017-01-24 |
| 1619213915 | Professional Recreation Organization, Inc. | Orthopaedic Surgery | 4455 148th Ave Ne, Bellevue, WA 98007 | 2012-12-14 |
| 1558488023 | Professional Recreation Organization, Inc. | Dietitian, Registered | 4455 148th Ave Ne, Bellevue, WA 98007-3120 | 2007-03-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PROFESSIONAL RECREATION ORGANIZATION, INC. | 4455 148th Ave Ne, Bellevue, WA 98007-3120 |
| Street Address |
4455 148TH AVE NE |
| City | BELLEVUE |
| State | WA |
| Zip Code | 98007-3120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831137892 | Pierce Edward Scranton Jr. | Orthopaedic Surgery | 4455 148th Ave Ne, Bellevue, WA 98007-3120 | 2006-06-03 |
| 1982238465 | Professional Recreation Organization, Inc. | Clinic/Center | 4455 148th Ave Ne, Bellevue, WA 98007-3120 | 2020-02-24 |
| 1821634924 | Lily Irene Nealon | Physical Therapist | 4455 148th Ave Ne, Bellevue, WA 98007-3120 | 2019-11-23 |
| 1841840436 | Galina Borisovna Riabinina | Physical Therapist | 4455 148th Ave Ne, Bellevue, WA 98007-3120 | 2019-09-16 |
| 1023663416 | Micah Jeremiah Armbrust | Physical Therapist | 4455 148th Ave Ne, Bellevue, WA 98007-3120 | 2019-08-03 |
| 1144708819 | Professional Recreation Organization, Inc. | Clinic/Center | 4455 148th Ave Ne, Bellevue, WA 98007-3120 | 2018-08-03 |
| 1245726538 | Professional Recreation Organization, Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4455 148th Ave Ne, Bellevue, WA 98007-3120 | 2018-07-10 |
| 1508352881 | Professional Recreation Organization, Inc. | Obstetrics & Gynecology | 4455 148th Ave Ne, Bellevue, WA 98007-3120 | 2018-07-10 |
| 1871080945 | Madeline Erin Kilpatrick | Social Worker | 4455 148th Ave Ne, Bellevue, WA 98007-3120 | 2018-04-15 |
| 1710496674 | Threasa Andrys | Naturopath | 4455 148th Ave Ne, Bellevue, WA 98007-3120 | 2017-09-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982204947 | Janet Delgado | Interpreter | 3000 Landerholm Cir Se, Bellevue, WA 98007 | 2020-10-29 |
| 1467092643 | Stephanie Schaal | Counselor | 15395 Se 30th Place Ste 120, Bellevue, WA 98007 | 2020-01-15 |
| 1740824358 | Alison Elizabeth Campbell | Massage Therapist | 14575 Ne Bel Red Rd Ste 100, Bellevue, WA 98007 | 2019-11-06 |
| 1275188021 | Pacific Coast Health Care, Pllc | Internal Medicine | Mission Healthcare At Bellevue, 2424 156th Avenue Ne, Bellevue, WA 98007 | 2019-08-08 |
| 1417475054 | Terasak Roeksbutr | Dietitian, Registered | 109 146th Ave Se, Bellevue, WA 98007 | 2017-09-04 |
| 1083130934 | Po-lung Wu | Acupuncturist | 693 156th Ave Se, Bellevue, WA 98007 | 2017-08-22 |
| 1689117319 | Audrey K. Tatt D.d.s. P.l.l.c. | Dentist | 15419 Ne 20th St. #206, Bellevue, WA 98007 | 2016-11-29 |
| 1952751836 | Mona Ebrahimi | Student in an Organized Health Care Education/Training Program | 14270 Ne 21st, Rainbow Creek, Bellevue, WA 98007 | 2016-06-21 |
| 1578939302 | Walgreen | Student in an Organized Health Care Education/Training Program | 15220 156th Ne, Bellevue, WA 98007 | 2015-08-17 |
| 1750767406 | Anar Veliyev | Physical Therapist | 14828 Ne 12th St, Bellevue, WA 98007 | 2015-08-05 |
| Find all providers in zip 98007 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255931416 | Lauren Dudugjian | Counselor | 1160 140th Ave Ne Ste E-f, Bellevue, WA 98005-2978 | 2020-10-27 |
| 1760080345 | Carli Rhylander | Counselor | 2009 Nottingham Dr, Bellevue, NE 68123-2046 | 2020-10-15 |
| 1023621877 | Eileen S Putter | Counselor | 14011 Se 49th Pl, Bellevue, WA 98006-3401 | 2020-08-30 |
| 1326657164 | Tamasin Raiswell | Counselor | 1611 116th Ave Ne Ste 211, Bellevue, WA 98004-3064 | 2020-07-28 |
| 1194349415 | Le Center for Health & Wellness, Inc. | Counselor | 15015 Main St Ste 210, Bellevue, WA 98007-5229 | 2020-06-02 |
| 1447888326 | Carlos M Del Rio | Counselor | 4009 Raynor Pkwy Apt 2120, Bellevue, NE 68123-6103 | 2020-03-27 |
| 1386270221 | Danthony T Smith | Counselor | 10608 Ne 2nd St, Bellevue, WA 98004-5157 | 2020-03-22 |
| 1538708169 | Anna L Redgrave | Counselor | 15659 Se 9th St, Bellevue, WA 98008-4901 | 2019-12-30 |
| 1508401142 | Jennifer Flores | Counselor | 3145 Whiteman Dr, Bellevue, NE 68123-1625 | 2019-11-07 |
| 1861037467 | Alyssa Rose Overton | Counselor | 1231 116th Ave Ne Ste 410, Bellevue, WA 98004-3804 | 2019-11-07 |
| Find all providers in BELLEVUE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.