NPIMap

Organization Active NPI

Proformance Rehab Inc

  • Physical Therapist
  • Seattle, WA
National Provider Identifier
1508801259
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00005317 Issued in WA
Legal business name
PROFORMANCE REHAB INC
Practice address
1550 Eastlake Ave E
Suite 100
Seattle, WA 98102-3728
Phone
(206) 322-2842
Fax
(206) 322-6232
NPI assigned
Jun 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Mark A Trombold, MSPTNPI 1598068876
Title
Owner
Phone
(206) 322-2842

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT00005317 WA Primary

Addresses

Primary practice location

1550 Eastlake Ave E
Suite 100
Seattle, WA 98102-3728

Mailing address

1550 Eastlake Ave E
Suite 100
Seattle, WA 98102-3728
Phone (206) 322-2842

National Provider Directory

National Provider Directory

Locations

2815 Eastlake Ave E
Ste 170
Seattle, WA 98102
Phone (206) 322-2842

1550 Eastlake Ave E
Ste 100
Seattle, WA 98102
Phone (206) 322-2842

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508801259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 EASTLAKE AVE E",
            "address_2": "SUITE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981023728",
            "telephone_number": "206-322-2842",
            "fax_number": "206-322-6232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 EASTLAKE AVE E",
            "address_2": "SUITE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981023728",
            "telephone_number": "206-322-2842",
            "fax_number": "206-322-6232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFORMANCE REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TROMBOLD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-322-2842",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00005317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.