PROLIANCE SURGEONS, INC., P.S. (NPI# 1417512021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417512021 |
| Entity Type | Organization |
| Organization Name | PROLIANCE SURGEONS, INC., P.S. |
| Other Organization Name | PROLIANCE ORTHOPEDIC ASSOCIATES |
| Practice Address |
1620 Lake Tapps Pkwy Se Ste 115 Auburn WA 98092-8376 |
| Mailing Address |
4011 Talbot Rd S Ste 300 Renton WA 98055-5791 |
| Practice Telephone | 2532462860 |
| Practice Fax Number | 2532462861 |
| Mailing Telephone | 4256565060 |
| Mailing Fax Number | 4256565047 |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2019-08-26 |
| 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 | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
Allopathic & Osteopathic Physicians | ||
| N | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 207XX0801X |
Orthopaedic Surgery Specialization: Orthopaedic Trauma |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Proliance Orthopedic Associates | 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 |
| 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 |
| 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 |
1620 LAKE TAPPS PKWY SE STE 115 |
| City | AUBURN |
| State | WA |
| Zip Code | 98092-8376 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942846241 | Therapy Management Services, Pllc | Durable Medical Equipment & Medical Supplies | 1620 Lake Tapps Pkwy Se Ste 115, Auburn, WA 98092-8376 | 2019-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679127922 | Washington Dental Corporation, PC | Dentist | 7084 Lakeland Hills Way, Suite 104, Auburn, WA 98092 | 2019-07-25 |
| 1659854784 | Brady Glenn Christoph | Physical Therapist | Auburn School District, 29205 132nd Ave Se, Auburn, WA 98092 | 2018-09-14 |
| 1588110217 | Elonna Alexanderovna Korolchuk | Nurse's Aide | 11223 Se 309th St, Auburn, WA 98092 | 2016-09-01 |
| 1053754416 | Alex E Broady | Counselor | 17300 Se 392nd Street, Auburn, WA 98092 | 2013-04-16 |
| 1801154828 | Aaron Soto Valencia | Counselor | 39101 180th Ave Se, Auburn, WA 98092 | 2012-04-27 |
| 1447467188 | D Lyn Dyan Lee | Massage Therapist | 1408 Lake Tapps Parkway East, Suite E106, Auburn, WA 98092 | 2007-05-16 |
| 1497817415 | Dale Allen Hansen | Chiropractor | 3321 Auburn Way South, Suite G, Auburn, WA 98092 | 2006-12-15 |
| 1922176874 | Kimberly B Fisher | Physical Therapist | 1408 Lake Tapps Parkway E, Suite E106, Auburn, WA 98092 | 2006-11-30 |
| 1760575450 | Roger Arthur Anderson | Dentist | 7125 224th Street Sw, Edmonds, WA 98092 | 2006-10-02 |
| 1053479907 | Nancy Louise Johnson | Physical Therapist | 1408 Lake Tapps Parkway E, Suite E106, Auburn, WA 98092 | 2006-12-04 |
| Find all providers in zip 98092 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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|---|---|---|---|---|
| 1730674326 | Regenesis LLC | Clinic/Center | 660 Auburn Folsom Rd Ste 203, Auburn, CA 95603-5646 | 2018-06-26 |
| 1013126937 | Auburn Pediatric and Adult Medicine, L.L.C. | Clinic/Center | 861-a North Dean Rd, Auburn, AL 36830 | 2007-05-21 |
| 1699708123 | Cayuga County | Clinic/Center | 146 North St, Auburn, NY 13021-1831 | 2006-07-08 |
| 1124008727 | Regents of The University of California | Clinic/Center | 3200 Bell Rd, Auburn, CA 95603-9244 | 2006-01-19 |
| 1982684528 | Regents of The University of Ca | Clinic/Center | 3111 Professional Dr, Auburn, CA 95603-2456 | 2006-01-19 |
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|---|---|---|---|---|
| 1326676818 | Nocd Washington PC | Clinic/Center | 2320 130th Ave Ne Ste 110, Bellevue, WA 98005-1752 | 2020-03-30 |
| 1922635887 | Cascade Nurse Practitioners | Clinic/Center | 5409 100th St Sw Unit 39800, Lakewood, WA 98496-0970 | 2020-03-23 |
| 1942735667 | The Evergreen At Northpoint | Clinic/Center | 2111 N Northgate Way Ste 101, Seattle, WA 98133-9018 | 2017-05-01 |
| 1174061543 | Antares Wellness Pllc | Clinic/Center | 9319 7th Ave S, Seattle, WA 98108-4604 | 2017-02-06 |
| 1962852038 | Northwest Pain Relief Centers, LLC | Clinic/Center | 503 W Fir St, Suite D, Sequim, WA 98382-3210 | 2016-06-20 |
| 1851741698 | Marconi Chiropractic and Wellness | Clinic/Center | 11207 Mccutcheon Rd, Bonney Lake, WA 98391-8103 | 2016-06-13 |
| 1356738694 | Northwest Pain Relief Centers LLC | Clinic/Center | 7424 Bridgeport Way W Ste 305, Lakewood, WA 98499-8135 | 2015-04-24 |
| 1306231170 | Objective Medical Assessments Corp | Clinic/Center | 401 2nd Ave S, #110, Seattle, WA 98104-3858 | 2015-03-30 |
| 1477946754 | Rose Urgent Care and Family Practice | Clinic/Center | 650 N Devine Rd Ste B, Vancouver, WA 98661-6979 | 2015-03-11 |
| 1336549609 | Ranger Group Pllc | Clinic/Center | 16150 Ne 85th St Ste 110, Redmond, WA 98052-3541 | 2014-08-24 |
| Find all providers with the same taxonomy | ||||
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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.