PROLIANCE SURGEONS, INC., P.S. (NPI# 1114108784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114108784 |
Entity Type | Organization |
Organization Name | PROLIANCE SURGEONS, INC., P.S. |
Other Organization Name | PROLIANCE SOUTH SEATTLE OTOLARYNGOLOGY |
Practice Address |
16259 Sylvester Rd Sw Ste 505 Burien WA 98166-3059 |
Practice Telephone | 2062423696 |
Practice Fax Number | 2062461078 |
Mailing Telephone | 2062423696 |
Mailing Fax Number | 2062461078 |
Enumeration Date | 2007-11-23 |
Last Update Date | 2020-02-21 |
Authorized Official Name | MR. KENNETH G. OVERBEY (COO) |
Authorized Official Telephone | 2068382583 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
Allopathic & Osteopathic Physicians | ||
N | 231H00000X | Audiologist | Speech, Language and Hearing Service Providers | ||
Y | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WA | WA L&I | 227694 | 01 |
WA | 1054623 | 05 |
Other Name | Type Code |
---|---|
Proliance South Seattle Otolaryngology | Doing Business As Name - Organization |
South Seattle Otolaryngology | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902418189 | Proliance Surgeons, Inc., P.s. | Orthopaedic Surgery | 2727 Hollycroft St Ste 410, Gig Harbor, WA 98335-1369 | 2020-08-19 |
1790325710 | Proliance Surgeons, Inc., P.s. | Radiology | 1101 Madison St Ste 580, Seattle, WA 98104-4305 | 2020-01-07 |
1104474808 | Proliance Surgeons, Inc., P.s. | Durable Medical Equipment & Medical Supplies | 1231 116th Ave Ne Ste 755, Bellevue, WA 98004-3804 | 2019-08-27 |
1417512021 | Proliance Surgeons, Inc., P.s. | Orthopaedic Surgery | 1620 Lake Tapps Pkwy Se Ste 115, Auburn, WA 98092-8376 | 2019-05-08 |
1205307253 | Proliance Surgeons, Inc., P.s. | Orthopaedic Surgery | 901 Boren Ave Ste 711, Seattle, WA 98104-3301 | 2018-12-16 |
1972073799 | Proliance Surgeons, Inc., P.s. | Orthopaedic Surgery | 150 Andover Park W, Tukwila, WA 98188-2801 | 2018-12-05 |
1184106262 | Proliance Surgeons, Inc., P.s. | Orthopaedic Surgery | 18100 Ne Union Hill Rd Ste 330, Redmond, WA 98052-3330 | 2018-09-05 |
1184140477 | Proliance Surgeons, Inc., P.s. | Radiology | 6808 220th St Sw Ste 105, Mountlake Terrace, WA 98043-2187 | 2017-08-17 |
1255736971 | Proliance Surgeons, Inc., P.s. | Surgery | 1519 3rd St Se Ste 210, Puyallup, WA 98372-3742 | 2014-10-23 |
1467883116 | Proliance Surgeons, Inc., P.s. | Physical Medicine & Rehabilitation | 1017 20th St, Anacortes, WA 98221-2505 | 2013-12-06 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | PROLIANCE SURGEONS, INC., P.S. | 805 Madison St Ste 901, Seattle, WA 98104-1172 |
Washington State Corporations | PROLIANCE SURGEONS, INC., P.S. | 805 Madison St Ste 901, Seattle, WA 98104-1172 |
Street Address |
16259 SYLVESTER RD SW STE 505 |
City | BURIEN |
State | WA |
Zip Code | 98166-3059 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568069656 | Allie Sims | Audiologist | 16259 Sylvester Rd Sw Ste 505, Burien, WA 98166-3059 | 2020-10-02 |
1992298814 | Samuel Grant Osborne | Audiologist | 16259 Sylvester Rd Sw Ste 505, Burien, WA 98166 | 2018-06-14 |
1962991349 | Janice Vong | Audiologist | 16259 Sylvester Rd Sw Ste 505, Burien, WA 98166 | 2018-05-01 |
1861629636 | Chad Victor Ruffin | Otolaryngology | 16259 Sylvester Rd Sw Ste 505, Burien, WA 98166-3059 | 2009-06-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508341488 | Robert James Woodland Sr. | Counselor | 1210 Sw 136th St., Burien, WA 98166 | 2018-09-26 |
1215467329 | Amy Elizabeth Castillo | Massage Therapist | 1204 Sw 168th St, Normandy Park, WA 98166 | 2017-06-13 |
1053856070 | Michael David Blackledge | Physical Therapist | 15811 Ambaum Blvd Sw Ste 140, Burien, WA 98166 | 2016-12-29 |
1114372232 | Maris Gibson | Massage Therapist | 801 S.w. 150thst, #110, Burien, WA 98166 | 2016-04-26 |
1649642992 | Navos | Community/Behavioral Health | 31408 28th Ave South, 1201 Sw 136th Street, Burien, WA 98166 | 2015-10-27 |
1154790798 | Han Nguyen | Chiropractor | 15811 Ambaum Blvd Sw Suite 110, Burien, WA 98166 | 2015-09-24 |
1497163778 | Maria Garvey-caruso | Physical Therapist | 1511 Ambaum Blvd South West, Suite 140, Burien, WA 98166 | 2014-07-30 |
1427495274 | Mohammed Nayeemuddin | Internal Medicine | 16259 Sylvester Rd Sw Ste 404, Burien, WA 98166 | 2013-06-03 |
1023362753 | Donna Shaman | Occupational Therapist | 15675 Ambaum Blvd, Burien, WA 98166 | 2012-11-02 |
1366707010 | Tracy C Saephanh | Pharmacy Technician | 14901 4th Ave Sw Ste 100, Burien, WA 98166 | 2012-07-09 |
Find all providers in zip 98166 |
Taxonomy Code | 207Y00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Otolaryngology |
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861629636 | Chad Victor Ruffin | Otolaryngology | 16259 Sylvester Rd Sw Ste 505, Burien, WA 98166-3059 | 2009-06-18 |
1174794267 | Patrick H Mcclean | Otolaryngology | 16259 Sylvester Rd Sw, Suite #505, Burien, WA 98166-3049 | 2008-03-17 |
1487664926 | Patrick H Mcclean | Otolaryngology | 16259 Sylvester Rd Sw, Suite 505, Burien, WA 98166-3049 | 2006-08-08 |
1356351886 | David C Green | Otolaryngology | 16259 Sylvester Rd Sw, Suite 505, Burien, WA 98166-3049 | 2006-08-08 |
1518974781 | Peter F Maurice IIi | Otolaryngology | 16259 Sylvester Rd Sw, Suite 505, Burien, WA 98166-3049 | 2006-08-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093220980 | Sound E.n.t. Consultants, LLC | Otolaryngology | 406 Yauger Way Sw Ste B, Olympia, WA 98502-8151 | 2017-12-13 |
1104203793 | Eric Andrew Eisen | Otolaryngology | 8301 161st Ave Ne Ste 102, Redmond, WA 98052-3858 | 2015-05-03 |
1598182990 | Annie Kyunga Ahn | Otolaryngology | 4033 Talbot Rd S Ste 540, Renton, WA 98055 | 2014-03-24 |
1760810311 | Gerald Guy Randolph | Otolaryngology | 10491 E State Route 106, Union, WA 98592 | 2013-10-17 |
1689007320 | Aria Jafari | Otolaryngology | 1959 Ne Pacific St # 356515, Seattle, WA 98195-3729 | 2013-08-16 |
1326306317 | Priyanka Shah O'brien | Otolaryngology | 1801 1st Ave Ste 3a, Longview, WA 98632-3271 | 2012-04-26 |
1033486402 | Richard J. Cavell | Otolaryngology | 1013 Marshall Dr, Camano Island, WA 98282-8787 | 2011-11-29 |
1457628497 | Robin Lee Downey | Otolaryngology | 4020 Aurora Ave N Apt 410, Seattle, WA 98103-7882 | 2011-11-18 |
1588955785 | Nicholas C Vanburen | Otolaryngology | 1424 N Mcdonald Rd Ste 101, Spokane Valley, WA 99216-6017 | 2011-04-22 |
1881925956 | Steve Lars Risa | Otolaryngology | 4538 177th Ave Se, Bellevue, WA 98006-6519 | 2010-01-28 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.