Organization
PROFESSIONAL RECREATION ORGANIZATION, INC.
Active
Other names
PRO Sports Club
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA BURGESS (MEDICAL BILLING & CREDENTIALING)
(425) 895-6575
Entity
Organization
Contact information
Practice address
4455 148TH AVE NE, BELLEVUE, WA 98007-3120
(425) 869-4746
(425) 869-5285
Mailing address
4455 148TH AVE NE, BELLEVUE, WA 98007-3120
(425) 869-4746
(425) 869-5285
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
600541508
WA
Other
Enumeration date
07/10/2018
Last updated
07/10/2018
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