Pro-Form Chiropractic and Sports Injury, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

PRO-FORM CHIROPRACTIC AND SPORTS INJURY, PLLC

Practice address

4041 Roosevelt Way NE Ste 101
Seattle, WA 98105-6579

Phone

(203) 312-3894

NPI assigned

Oct 14, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Nicholas Petrini, DC

Title

Chiropractor/Owner

Phone

(206) 705-3088

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1871256180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5534 84TH DR NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982708509",
            "telephone_number": "203-312-3894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4041 ROOSEVELT WAY NE STE 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056579",
            "telephone_number": "203-312-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-FORM CHIROPRACTIC AND SPORTS INJURY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-14",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "PETRINI",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "206-705-3088",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Denise Olivia Pritzl, LICSW
• Evelyn S Prizont, LMFTA
• Proactive Home Care, LLC
• Joshua David Proal, MD
• Fernando Diego Proano, M.D.
• Pablo R Proano, M.D.
• Jeffrey Lynn Probstfield, MD

• Chiropractor in Seattle, WA
• Providers in Seattle, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.