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

Professional Recreation Organization, Inc

Organization Dermatology Physician · NPI 1700920782

Professional Recreation Organization, Inc is a Dermatology Physician in Bellevue, Washington. Licensed in Washington. Registered with an NPI since 2007.

Licensed in
WA
In the registry since
2007
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4455 148th Ave NE
Bellevue, WA 98007-3120
Phone: (425) 895-6546
Fax: (425) 861-6277
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 600541508 (WA)
Physician Assistant Taxonomy 363A00000X · Licence 600541508 (WA)

Record details

NPI number1700920782
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Debbie Becker — Sr Director Of Accounting · (425) 869-4746
Other names Pro Sports Club
NPI enumeratedFebruary 16, 2007
Last updated in NPPESAugust 7, 2017
Mailing address4455 148th Ave Ne, Bellevue, WA 98007-3120

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