PROLIANCE SURGEONS, INC., P.S. (NPI# 1255736971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255736971 |
| Entity Type | Organization |
| Organization Name | PROLIANCE SURGEONS, INC., P.S. |
| Other Organization Name | PUYALLUP SURGICAL CONSULTANTS |
| Practice Address |
1519 3rd St Se Ste 210 Puyallup WA 98372-3742 |
| Practice Telephone | 2534451844 |
| Practice Fax Number | 2538647356 |
| Mailing Telephone | 2534451844 |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2020-10-26 |
| 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 | 2086X0206X |
Surgery Specialization: Surgical Oncology |
601484763 | WA | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | 601484763 | WA | Allopathic & Osteopathic Physicians |
| N | 208C00000X | Colon & Rectal Surgery | 601484763 | WA | Allopathic & Osteopathic Physicians |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 208600000X | Surgery | 601484763 | WA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Puyallup Surgical Consultants | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1519 3rd St Se Ste 230, Puyallup, WA 983723742 | 4254451844 | 4258647356 |
| 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 |
| 1467883116 | Proliance Surgeons, Inc., P.s. | Physical Medicine & Rehabilitation | 1017 20th St, Anacortes, WA 98221-2505 | 2013-12-06 |
| 1427356211 | Proliance Surgeons, Inc., P.s. | Physical Medicine & Rehabilitation | 2720 Commercial Ave, Anacortes, WA 98221-2750 | 2011-03-03 |
| 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 |
1519 3RD ST SE STE 210 |
| City | PUYALLUP |
| State | WA |
| Zip Code | 98372-3742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371532 | Jeffrey Allen Zhan | Urology | Good Samaritan Medical Office Bldg 1450 5th St Se, Suite 2100- Urology Clinic, Puyallup, WA 98372 | 2019-11-21 |
| 1447811419 | Serenity Counseling & Consulting, LLC | Marriage & Family Therapist | 102 23rd St Se, Unit B, Puyallup, WA 98372 | 2019-06-21 |
| 1316401565 | Katherine Juarez Davidson | Nurse Practitioner | 325 E Pioneer # A145, Puyallup, WA 98372 | 2019-01-22 |
| 1679041404 | Cara Ann Lundin | Nurse Practitioner | 11926 43rd St Crt E, Edgewood, WA 98372 | 2018-11-09 |
| 1104392109 | Megan Black | Occupational Therapist | 40 29th St Ne, Puyallup, WA 98372 | 2018-10-17 |
| 1063919470 | Myriah Shekinah Olakpe | Occupational Therapist | 516 Se 23rd Ave, Puyallup, WA 98372 | 2018-04-11 |
| 1902330202 | Tyler Girdler | Student in an Organized Health Care Education/Training Program | 1322 3rd Street Se Suite 240, Puyallup, WA 98372 | 2017-04-13 |
| 1770039471 | Mahalakshmi Hariharan | Pharmacist | 2117 28th St Se, Puyallup, WA 98372 | 2016-09-01 |
| 1801241112 | Nawazish Ali | Internal Medicine | 401 15th Ave Se Multicare God Samartian Hopsital, Puyallup, WA 98372 | 2016-04-25 |
| 1932567559 | Denice L. Voss | Physical Therapist | 400 29th St. Ne, Puyallup, WA 98372 | 2016-02-10 |
| Find all providers in zip 98372 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568809465 | Michael Marshall | Surgery | 1322 3rd Street Se, Suite 240, Ms 1322-2-efm, East Pierce Family Medicine, Puyallup, WA 98371-0192 | 2013-05-31 |
| 1649346347 | Robert Charles Wright | Surgery | 208 17th Ave Se, Suite 201, Puyallup, WA 98372-4515 | 2006-11-27 |
| 1710930896 | Christopher Neuman Petty | Surgery | 1519 3rd St Se, Ste 230, Puyallup, WA 98372-3724 | 2006-05-18 |
| 1699736942 | Mark Jonathan Snell | Surgery | 1450 5th St Se, Ste 4300, Puyallup, WA 98372-4511 | 2006-03-28 |
| 1053764522 | Yarrow J. Mcconnell | Surgery | 1519 3rd St Se, Suite 230, Puyallup, WA 98372-3742 | 2016-07-19 |
| 1316360639 | Brian Nelson | Surgery | 208 17th Ave Se, Puyallup, WA 98372-4515 | 2014-01-22 |
| 1841516879 | Lam Phuong Thi Nguyen | Surgery | 1450 5th St Se, Ste 3600, Puyallup, WA 98372-4602 | 2010-04-15 |
| 1194991570 | Gabriela M Vargas | Surgery | 1519 3rd St Se Ste 230, Puyallup, WA 98372-3742 | 2008-05-05 |
| 1174725402 | Cascade Hernia and Surgical Solutions Ps | Surgery | 208 17th Ave Se, Ste 201, Puyallup, WA 98372-4515 | 2007-05-31 |
| 1508907106 | Sound Surgical Associates | Surgery | 1322 3rd St Se, Suite 220, Puyallup, WA 98372-3771 | 2007-02-08 |
| Find all providers in PUYALLUP | ||||
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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.