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General NPI Number Information
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NPI Number | 1982554341
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Entity Type | Organization
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Legal Business Name | PROHEALTH MEDICAL
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Dates
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Enumeration Date | 02/03/2026
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 14645 NE BEL RED RD STE 103
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City | BELLEVUE
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State | WA
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Zip | 98007-3929
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Country | US
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Telephone | 425-502-8098
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Fax | 866-521-0472
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Provider Business Mailing Address
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Address Line | 2623 E HELEN ST
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City | SEATTLE
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State | WA
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Zip | 98112-3619
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Country | US
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Telephone | 425-502-8098
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Fax | 866-521-0472
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Authorized Official
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Title or Position | OWNER/LEAD PHYSICIAN
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Name | JENA RIVERS
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Credential | MD
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Telephone | 206-963-6500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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