Prohealth Medical, LTD.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

PROHEALTH MEDICAL, LTD.

Practice address

1233 120TH Ave NE
Bellevue, WA 98005-2147

Phone

(425) 502-8098

Fax

(866) 521-0472

NPI assigned

Oct 15, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jena Lariviere Rivers, M.D.NPI 1730124231

Title

Owner

Phone

(206) 963-6500

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jena Lariviere Rivers, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Bellevue, WA
  • NPI 1730124231
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413331200000",
    "number": "1386048668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2623 E HELEN ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981123619",
            "telephone_number": "206-963-6500",
            "fax_number": "866-521-0472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 120TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052147",
            "telephone_number": "425-502-8098",
            "fax_number": "866-521-0472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH MEDICAL, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-15",
        "last_updated": "2014-10-15",
        "status": "A",
        "authorized_official_last_name": "RIVERS",
        "authorized_official_first_name": "JENA",
        "authorized_official_middle_name": "LARIVIERE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-963-6500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Professional Recreation Organization, Inc.
• Professional Recreation Organization, Inc.
• Professional Recreation Organization, Inc.
• Progressive Dentistry, Inc.
• Prohealth Medical
• Milana Prokopenko, LMHCA
• Proliance Surgeons Inc P S
• Proliance Surgeons Inc P S
• Proliance Surgeons Inc P S
• Proliance Surgeons Inc PS

• Medical Specialty Clinic/Center in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Medical Specialty Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.