Healthcare Provider Details

I. General information

NPI: 1568579944
Provider Name (Legal Business Name): UNITED BACKCARE PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9617 7TH AVE SE
EVERETT WA
98208-3710
US

IV. Provider business mailing address

9617 7TH AVE SE
EVERETT WA
98208-3710
US

V. Phone/Fax

Practice location:
  • Phone: 425-513-8509
  • Fax: 425-290-9774
Mailing address:
  • Phone: 425-513-8509
  • Fax: 425-290-9774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARY E SPORES
Title or Position: OWNER
Credential: OTR
Phone: 425-513-8509