PROLIANCE SURGEONS, INC., P.S. (NPI# 1275726739) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275726739 |
| Entity Type | Organization |
| Organization Name | PROLIANCE SURGEONS, INC., P.S. |
| Other Organization Name | PROLIANCE EASTSIDE ENT |
| Practice Address |
1800 116th Ave Ne Suite 102 Bellevue WA 98004-3043 |
| Mailing Address |
805 Madison St. Suite 901 Seattle WA 98104-1172 |
| Practice Telephone | 4254513710 |
| Practice Fax Number | 4254512636 |
| Mailing Telephone | 2062648100 |
| Mailing Fax Number | 2062648689 |
| Enumeration Date | 2007-08-19 |
| Last Update Date | 2011-10-31 |
| Authorized Official Name | MR. DAVID G. FITZGERALD (CEO) |
| Authorized Official Telephone | 2068382599 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 601484763 | WA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Proliance Eastside ENT | 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 |
1800 116TH AVE NE SUITE 102 |
| City | BELLEVUE |
| State | WA |
| Zip Code | 98004-3043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871592014 | Peggy Kibbel | Nurse Practitioner | 1800 116th Ave Ne, Suite 201, Bellevue, WA 98004-3043 | 2005-07-19 |
| 1851758353 | Melisa Lin, Dmd, Pllc | Dentist | 1800 116th Ave Ne, Suite #105, Bellevue, WA 98004-3043 | 2016-01-28 |
| 1457732307 | Posner & Barbizam Pllc | Dentist | 1800 116th Ave Ne, Suite #202, Bellevue, WA 98004-3043 | 2015-06-17 |
| 1497049696 | Melisa Lin | Dentist | 1800 116th Ave Ne, Suite #105, Bellevue, WA 98004-3043 | 2011-06-06 |
| 1891949871 | Janice Lynn Driver | Psychologist | 1800 116th Ave Ne, Suite 104, Bellevue, WA 98004-3043 | 2008-11-04 |
| 1124295423 | William Gregory Young Jr. | Otolaryngology | 1800 116th Ave Ne, Suite 102, Bellevue, WA 98004-3043 | 2008-05-15 |
| 1104949239 | Donald Alan Snyder | Dentist | 1800 116th Ave Ne, Suite 105, Bellevue, WA 98004-3043 | 2007-04-06 |
| 1912028952 | Donald Snyder, Dds, Ps | Dentist | 1800 116th Ave Ne, Suite 105, Bellevue, WA 98004-3043 | 2007-04-03 |
| 1578660619 | James David Johnson | Dentist | 1800 116th Ave Ne, Suite 202, Bellevue, WA 98004 | 2006-09-20 |
| 1144327230 | Patrick E Taylor | Dentist | 1800 116th Ave Ne, Suite 202, Bellevue, WA 98004 | 2006-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306458328 | Geneva Paula Hoskins-dorsey | Nurse Practitioner | 11120 Ne 33rd Place, Suite 202, Bellevue, WA 98004 | 2020-08-20 |
| 1720553613 | Christine Eyler | Pediatrics | Bellevue Pediatrics, C & C Medical Associates, 1940 116th Ave Ne, Ste 200, Bellevue, WA 98004 | 2018-10-08 |
| 1437634730 | Hazelden Betty Ford Foundation | Clinic/Center | 1231 116th Ave. Ne Suite 410, Bellevue, WA 98004 | 2018-10-02 |
| 1356827828 | Seattle Spine Group, Pllc | Orthopaedic Surgery | 1220 116th Ave Ne Ste 102, Bellevue, WA 98004 | 2018-07-17 |
| 1669989216 | Atsuko Nakajima | Acupuncturist | 2223 112th Ave. Ne, Ste 201, Bellevue, WA 98004 | 2018-01-04 |
| 1740794718 | Radka Chapin Counseling, LLC | Clinic/Center | 1611 116th Ave Ne Ste 119, Bellevue, WA 98004 | 2017-11-28 |
| 1962912105 | Cuyler Ann Simmons | Counselor | 3805 108th Ave Ne Ste 204, Bellevue, WA 98004 | 2017-10-02 |
| 1639690357 | Nicolas Lopez-montalvo | Behavioral Analyst | 3003 Northup Way Suite 200, Bellevue, WA 98004 | 2017-07-03 |
| 1124579537 | Matthew Thomas Haley | Pharmacist | 107 Bellevue Way, Se, Bellevue, WA 98004 | 2016-10-20 |
| 1649727348 | Kelsey Tanaka | Nurse Practitioner | 400- 108th Ave Ne, Suite 100, Bellevue, WA 98004 | 2016-09-10 |
| Find all providers in zip 98004 | ||||
| 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 |
|---|---|---|---|---|
| 1881925956 | Steve Lars Risa | Otolaryngology | 4538 177th Ave Se, Bellevue, WA 98006-6519 | 2010-01-28 |
| 1124260351 | Adrienne Maria Laury | Otolaryngology | 1231 116th Ave Ne Ste 915, Bellevue, WA 98004 | 2009-04-02 |
| 1023265261 | James Matthew Ridgway | Otolaryngology | 1231 116th Ave Ne Ste 900, Bellevue, WA 98004-3822 | 2008-08-19 |
| 1679669782 | Philip A Young | Otolaryngology | 1810 116th Ave Ne Ste 102, Bellevue, WA 98004-3058 | 2006-10-05 |
| 1740393461 | Natalie P Higgins | Otolaryngology | 1800 116th Ave Ne Ste 102, Bellevue, WA 98004 | 2006-08-16 |
| 1467680108 | Anh Quoc Truong | Otolaryngology | 1231 116th Ave Ne, Suite 915, Bellevue, WA 98004-3804 | 2009-07-01 |
| 1124295423 | William Gregory Young Jr. | Otolaryngology | 1800 116th Ave Ne, Suite 102, Bellevue, WA 98004-3043 | 2008-05-15 |
| 1255500542 | Proliance Surgeons, Inc., P.s. | Otolaryngology | 1231 116th Ave Ne, Suite 915, Bellevue, WA 98004-3804 | 2008-02-21 |
| 1659566560 | Trac M. Duong | Otolaryngology | 1231 116th Ave Ne, Suite 915, Bellevue, WA 98004-3804 | 2007-09-13 |
| 1023218617 | Jonathan Chaim Kopelovich | Otolaryngology | 1231 116th Ave Ne, Suite 915, Bellevue, WA 98004-3804 | 2007-07-20 |
| Find all providers in BELLEVUE | ||||
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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.