Healthcare Provider Details
I. General information
NPI: 1407778707
Provider Name (Legal Business Name): SOUND SPORTS PERFORMANCE AND REHAB
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1423 10TH AVE STE D
SEATTLE WA
98122-3889
US
IV. Provider business mailing address
732 11TH AVE E APT 101
SEATTLE WA
98102-4654
US
V. Phone/Fax
- Phone: 564-234-0213
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NS0005X |
| Taxonomy | Sports Physician Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MARK
BELANGER
Title or Position: OWNER
Credential: DC
Phone: 330-283-2153