PROLIANCE SURGEONS, INC., P.S. (NPI# 1750320701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750320701 |
| Entity Type | Organization |
| Organization Name | PROLIANCE SURGEONS, INC., P.S. |
| Other Organization Name | EVERETT BONE AND JOINT MRI |
| Practice Address |
1100 Pacific Ave Suite 300 Everett WA 98201-4261 |
| Mailing Address |
1100 Pacific Ave Ste 300 Everett WA 98201-4261 |
| Practice Telephone | 4253392433 |
| Practice Fax Number | 4253398273 |
| Mailing Telephone | 4253392433 |
| Mailing Fax Number | 4253398273 |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2020-03-06 |
| 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 | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2471M1202X |
Radiologic Technologist Specialization: Magnetic Resonance Imaging |
Technologists, Technicians & Other Technical Service Providers | ||
| N | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
Ambulatory Health Care Facilities | ||
| N | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities | ||
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2012655 | 05 | |
| WA | WA LABOR & INDUSTRIES | 123308 | 01 |
| Other Name | Type Code |
|---|---|
| Everett Bone and Joint | Doing Business As Name - Organization |
| Everett Bone and Joint MRI | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 19200 N Kelsey St, Monroe, WA 982721431 | 4253392433 | 4253398273 |
| 3102 Colby Ave, Everett, WA 982014025 | 4252588110 | 4252586281 |
| 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 |
1100 PACIFIC AVE SUITE 300 |
| City | EVERETT |
| State | WA |
| Zip Code | 98201-4261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073503181 | Roxanne E Hertzog | Anesthesiology | 1100 Pacific Ave, Suite 100, Everett, WA 98201-4261 | 2005-10-28 |
| 1659751949 | Melissa Ann Morris | Registered Nurse | 1100 Pacific Ave, Suite 300, Everett, WA 98201-4261 | 2015-06-02 |
| 1073847240 | Mono Nhean | Occupational Therapist | 1100 Pacific Ave, Suite 201, Everett, WA 98201-4261 | 2009-09-21 |
| 1083871305 | Douglas D Nowak | Orthopaedic Surgery | 1100 Pacific Ave, Suite 300, Everett, WA 98201-4261 | 2008-05-22 |
| 1003082017 | John D Pryor | Orthopaedic Surgery | 1100 Pacific Ave, Suite 300, Everett, WA 98201-4261 | 2008-04-30 |
| 1245412535 | Mark Western Mashita | Physician Assistant | 1100 Pacific Ave, Suite 300, Everett, WA 98201-4261 | 2007-11-29 |
| 1801001805 | Alex H Kang | Dentist | 1100 Pacific Ave, Suite 200, Everett, WA 98201-4261 | 2007-05-12 |
| 1043433352 | Penny Goudelock | Physician Assistant | 1100 Pacific Ave, Suite 202, Everett, WA 98201-4261 | 2007-04-11 |
| 1922132646 | Christine L Hayes | Registered Nurse | 1100 Pacific Ave, Suite 300, Everett, WA 98201-4261 | 2007-03-15 |
| 1003945643 | Richard L Semon | Orthopaedic Surgery | 1100 Pacific Ave, Suite 300, Everett, WA 98201-4261 | 2007-03-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306471867 | Shannon Michelle Dewald | Registered Nurse | D8s 1700 13th St, Everett, WA 98201 | 2020-03-05 |
| 1578123113 | Precious Medicial Spa, LLC | Registered Nurse | 1728 W. Marine View Dr Suite 212, Everett, WA 98201 | 2019-06-17 |
| 1508429796 | Alix Deschain | Counselor | 2801 Broadway, Everett, WA 98201 | 2019-04-15 |
| 1811457534 | Khushboo Patel | Pharmacist | 1330 Rockefeller Ave Ste 150, Everett, WA 98201 | 2019-03-20 |
| 1164991188 | Grace Talbot Davis | Registered Nurse | 2601 Summit Avenue, Bldg. C, Everett, WA 98201 | 2018-11-20 |
| 1063924603 | Tracy Sisk | Counselor | 3120 Colby Ave, 502, Everett, WA 98201 | 2017-11-03 |
| 1710403126 | Michelle Durham | Counselor | 3322 Boadway Fl 2, Everett, WA 98201 | 2017-08-17 |
| 1861927949 | Melanie Schmidt | Counselor | 2610 Westmore Ave, Everett, WA 98201 | 2017-04-26 |
| 1518413327 | Joseph Madson Dmd Pllc | Clinic/Center | 3802 Colby Ave, 4th Floor, Everett, WA 98201 | 2016-08-31 |
| 1043683162 | Jennifer Adams | Counselor | 1511 26th St, Everett, WA 98201 | 2015-11-11 |
| Find all providers in zip 98201 | ||||
| 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 |
|---|---|---|---|---|
| 1376612093 | James Glah | Orthopaedic Surgery | 249 Hospital Dr, Everett, PA 15537-7020 | 2006-11-07 |
| 1972550556 | Robin Lynn Madsen | Orthopaedic Surgery | 1100 Pacific Ave Ste 300, Everett, WA 98201-4261 | 2006-05-28 |
| 1811445968 | Apex Surgeons, Ps | Orthopaedic Surgery | 3305 Nassau St, Everett, WA 98201-4140 | 2016-09-19 |
| 1194137968 | Jonathan J Vaux | Orthopaedic Surgery | 3927 Rucker Ave, Everett, WA 98201-4833 | 2014-05-28 |
| 1699195990 | Mithun Neral | Orthopaedic Surgery | 3726 Broadway Ste 201, Everett, WA 98201-3788 | 2014-04-24 |
| 1336439116 | Tyler Kent | Orthopaedic Surgery | 3726 Broadway Ste 201, Everett, WA 98201 | 2011-04-13 |
| 1639468259 | Providence Health & Services - Wa | Orthopaedic Surgery | 1717 13th St, Suite 401, Everett, WA 98201-1621 | 2011-04-05 |
| 1770897589 | Siddharth Bhola | Orthopaedic Surgery | 1100 Pacific Ave Ste 300, Everett, WA 98201-4261 | 2010-08-04 |
| 1033352968 | Alireza K Anissipour | Orthopaedic Surgery | 3726 Broadway, Suite 201, Everett, WA 98201-3787 | 2009-04-07 |
| 1700040086 | Meredith C Larsen | Orthopaedic Surgery | 3927 Rucker Ave, Everett, WA 98201-4833 | 2008-07-15 |
| Find all providers in EVERETT | ||||
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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.