PROLIANCE SURGEONS, INC., P.S. (NPI# 1629409297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629409297 |
| Entity Type | Organization |
| Organization Name | PROLIANCE SURGEONS, INC., P.S. |
| Other Organization Name | SKAGIT NORTHWEST ORTHOPEDCIS-MT.VERNON/CONTINENTAL |
| Practice Address |
1500 Continental Pl Mount Vernon WA 98273-4105 |
| Mailing Address |
805 Madison St Suite 901 Seattle WA 98104-1172 |
| Practice Telephone | 3604247041 |
| Practice Fax Number | 3604848449 |
| Mailing Telephone | 2062648100 |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2014-08-04 |
| 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 |
|---|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation | 601484763 | WA | Allopathic & Osteopathic Physicians |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
601484763 | WA | Podiatric Medicine & Surgery Service Providers |
| N | 225100000X | Physical Therapist | 601484763 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 225X00000X | Occupational Therapist | 601484763 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
601484763 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207X00000X | Orthopaedic Surgery | 601484763 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | MEDICARE PTAN | GAB03033 | 01 |
| Other Name | Type Code |
|---|---|
| SKAGIT NORTHWEST ORTHOPEDCIS-MT.VERNON/CONTINENTAL | 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 |
1500 CONTINENTAL PL |
| City | MOUNT VERNON |
| State | WA |
| Zip Code | 98273-4105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760480545 | Patrick M Lyons | Orthopaedic Surgery | 1500 Continental Pl, Mount Vernon, WA 98273-4105 | 2005-07-14 |
| 1679130322 | Guillermo Vales Kennedy | Physician Assistant | 1500 Continental Pl, Mount Vernon, WA 98273 | 2019-05-28 |
| 1235694936 | Kristen Erin Roberts | Physician Assistant | 1500 Continental Pl, Mount Vernon, WA 98273-4105 | 2019-02-06 |
| 1528484490 | Caryn Anne Clippert | Physician Assistant | 1500 Continental Pl, Mount Vernon, WA 98273-4105 | 2014-03-14 |
| 1376988477 | Ryan James Nathe | Orthopaedic Surgery | 1500 Continental Pl, Mount Vernon, WA 98273 | 2013-05-02 |
| 1851666929 | Herbie Yung | Physical Medicine & Rehabilitation | 1500 Continental Pl, Mount Vernon, WA 98273-4105 | 2012-03-21 |
| 1194024448 | Camille Lauren Connelly | Orthopaedic Surgery | 1500 Continental Pl, Mount Vernon, WA 98273-4105 | 2011-03-24 |
| 1669426417 | Robert James Rogers | Physician Assistant | 1500 Continental Pl, Mount Vernon, WA 98273-4105 | 2006-05-19 |
| 1932109691 | Ivory V Larry | Physician Assistant | 1500 Continental Pl, Mount Vernon, WA 98273-4105 | 2005-07-26 |
| 1457350712 | Proliance Surgeons, Inc., P.s. | Clinic/Center | 1500 Continental Pl, Mount Vernon, WA 98273-4105 | 2005-07-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710585849 | Stephanie Marie Partington | Physical Therapist | 1901 Hoad Road, Mount Vernon, WA 98273 | 2020-10-12 |
| 1447866165 | Jennifer I Campos | Interpreter | 1501 Sunset Pl., Unit B, Mount Vernon, WA 98273 | 2020-09-17 |
| 1487217345 | Nicholas Peter Goodman | Student in an Organized Health Care Education/Training Program | Attn: Internal Medicine Residency, 300 Hospital Parkway, Mount Vernon, WA 98273 | 2019-04-17 |
| 1023579430 | Joan Watkins Opyr | Registered Nurse | Telecare North Sound E&t, 7825 North Sound Drive, Sedro-woolley, WA 98273 | 2019-03-28 |
| 1588136188 | Nicholas Bryan Corp | Physical Therapy Assistant | 1901 Hoag Road, Mount Vernon, WA 98273 | 2018-12-20 |
| 1518437300 | Eyonna Mason | Case Manager/Care Coordinator | 1100 52nd St, Mount Vernon, WA 98273 | 2018-12-05 |
| 1023515400 | Evergreen Recovery Centers | Substance Abuse Rehabilitation Facility | 1905 Continental Place, Mount Vernon, WA 98273 | 2018-04-11 |
| 1104320480 | Stacy Anne Black | Marriage & Family Therapist | 2301 Old Hwy 99, Mt. Vernon, WA 98273 | 2018-03-21 |
| 1609387844 | Kerri Jesse | Massage Therapist | 210 N 23rd St, Mount Vernon, WA 98273 | 2017-10-16 |
| 1992225320 | Juana Cleek | Registered Nurse | 330 Pacific Place, Mount Vernon, WA 98273 | 2017-06-27 |
| Find all providers in zip 98273 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| 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 Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679539019 | John Gordon Rowe | Orthopaedic Surgery | 302 Broadway St, Mount Vernon, IL 62864 | 2006-04-25 |
| 1609835354 | Kenneth Herbert Doolittle II | Orthopaedic Surgery | 1375 Yauger Rd, Suite A, Mount Vernon, OH 43050 | 2006-03-21 |
| 1760480545 | Patrick M Lyons | Orthopaedic Surgery | 1500 Continental Pl, Mount Vernon, WA 98273-4105 | 2005-07-14 |
| 1588662472 | Kaarsten Robin Lang | Orthopaedic Surgery | 1401 S Laventure Rd, Mount Vernon, WA 98274-6033 | 2005-07-13 |
| 1447770920 | Cumberland Foot and Ankle Centers | Orthopaedic Surgery | 140 Newcomb Ave, Mount Vernon, KY 40456-2725 | 2017-06-26 |
| 1386038164 | Christopher M Thomas | Orthopaedic Surgery | 1400 E Kincaid St, Mount Vernon, WA 98274-4127 | 2015-03-19 |
| 1376988477 | Ryan James Nathe | Orthopaedic Surgery | 1500 Continental Pl, Mount Vernon, WA 98273 | 2013-05-02 |
| 1194024448 | Camille Lauren Connelly | Orthopaedic Surgery | 1500 Continental Pl, Mount Vernon, WA 98273-4105 | 2011-03-24 |
| 1659508299 | Christopher L. Sheu | Orthopaedic Surgery | 2320 Freeway Drive, Mount Vernon, WA 98273 | 2009-06-21 |
| 1386890234 | Juan Alfredo Carrillo | Orthopaedic Surgery | 302 Broadway St, Mount Vernon, IL 62864-5116 | 2008-08-12 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 98273 |
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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.