Organization
PROFESSIONAL RECREATION ORGANIZATION, INC.
Active
Other names
PRO Sports Club
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE BECKER (SR DIRECTOR OF ACCOUNTING)
(425) 869-4746
Entity
Organization
Contact information
Practice address
4455 148TH AVE NE, BELLEVUE, WA 98007-3120
(425) 895-6546
(425) 861-6277
Mailing address
4455 148TH AVE NE, BELLEVUE, WA 98007-3120
(425) 895-6546
(425) 861-6277
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
600541508
WA
363A00000X
Physician Assistant
600541508
WA
Other
Enumeration date
02/16/2007
Last updated
08/07/2017
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