PROLIANCE SURGEONS, INC., P.S. (NPI# 1538343033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538343033 |
| Entity Type | Organization |
| Organization Name | PROLIANCE SURGEONS, INC., P.S. |
| Other Organization Name | PROLIANCE SOUTHWEST SEATTLE ORTHOPEDICS |
| Practice Address |
16259 Sylvester Rd Sw Suite 501 Burien WA 98166-3049 |
| Mailing Address |
805 Madison St Suite 901 Seattle WA 98104-1172 |
| Practice Telephone | 2062431100 |
| Practice Fax Number | 2064310835 |
| Mailing Telephone | 2062648100 |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2013-12-30 |
| 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 | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Proliance Southwest Seattle Orthopedics | 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 SUITE 501 |
| City | BURIEN |
| State | WA |
| Zip Code | 98166-3049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841293511 | William L Clark | Orthopaedic Surgery | 16259 Sylvester Rd Sw, Ste 501, Burien, WA 98166-3059 | 2005-05-24 |
| 1386101244 | Monica Elizabeth Mann | Physical Therapy Assistant | 16259 Sylvester Rd Sw, Burien, WA 98166-3049 | 2019-02-27 |
| 1215400270 | William Seth Carey | Physical Therapy Assistant | 16259 Sylvester Rd Sw, Burien, WA 98166-3049 | 2019-01-02 |
| 1225515471 | Sarah Mattingly | Physical Therapist | 16259 Sylvester Rd Sw, Burien, WA 98166-3049 | 2018-07-20 |
| 1235625377 | Derek Kenneth Mixon | Physical Therapist | 16259 Sylvester Rd Sw, Burien, WA 98166-3049 | 2018-07-02 |
| 1861919268 | Sally Garland | Physical Therapist | 16259 Sylvester Rd Sw, Burien, WA 98166-3049 | 2017-08-25 |
| 1023556727 | Caitlyn Cutshall | Physical Therapist | 16259 Sylvester Rd Sw, Suite 102, Burien, WA 98166-3049 | 2017-02-02 |
| 1538604855 | Tiffany Siu | Physical Therapist | 16259 Sylvester Rd Sw, Three Tree Medical Arts Bldg, Suite 102, Burien, WA 98166-3049 | 2016-12-21 |
| 1821480518 | Paige E Whiteley | Audiologist | 16259 Sylvester Rd Sw, Suite 505, Burien, WA 98166-3049 | 2015-03-04 |
| 1396153334 | Sara Harbi Abdallah Elshafei | Audiologist | 16259 Sylvester Rd Sw, Suite 505, Burien, WA 98166-3049 | 2014-07-22 |
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| 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 | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962444885 | Roger Y Wong | Orthopaedic Surgery | 16259 Sylvester Rd Sw, Suite 501, Burien, WA 98166-3049 | 2006-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972073799 | Proliance Surgeons, Inc., P.s. | Orthopaedic Surgery | 150 Andover Park W, Tukwila, WA 98188-2801 | 2018-12-05 |
| 1376751669 | Christopher J. Van Hofwegen | Orthopaedic Surgery | 2979 Squalicum Pkwy Ste 203, Bellingham, WA 98225-1813 | 2007-05-18 |
| 1194822874 | Amaryllis J. Scott | Orthopaedic Surgery | 785 E Holland Ave, Spokane, WA 99218-1257 | 2006-09-17 |
| 1477572931 | James J Wyman | Orthopaedic Surgery | 11212 Sunrise Blvd E Ste 201, Puyallup, WA 98374-8847 | 2006-07-18 |
| 1295774016 | Public Hospital Dist No 1 Skagit | Orthopaedic Surgery | 328 S. Stillaguamish Ave., Arlington, WA 98223-1660 | 2006-06-06 |
| 1205887056 | Christopher George Anderson | Orthopaedic Surgery | 12410 East Sinto, Suite 210, Spokane, WA 99216 | 2006-05-15 |
| 1942250535 | Vincent M Santoro | Orthopaedic Surgery | 12333 Ne 130th Lane, #400, Kirkland, WA 98034-7467 | 2006-05-12 |
| 1720040371 | Phillip A Medina | Orthopaedic Surgery | 4361 Talbot Road S, #102, Renton, WA 98055 | 2006-04-06 |
| 1356326870 | Donald William Henline | Orthopaedic Surgery | 3726 Broadway Ste 201, Everett, WA 98201-3788 | 2005-12-07 |
| 1679122758 | Taylor Nicole Fowers | Orthopaedic Surgery | 12039 Ne 128th St Ste 400, Kirkland, WA 98034-3029 | 2019-09-10 |
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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.