PROLIANCE SURGEONS, INC., P.S. (NPI# 1811274459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811274459 |
| Entity Type | Organization |
| Organization Name | PROLIANCE SURGEONS, INC., P.S. |
| Other Organization Name | NORTHWEST ORTHOPAEDIC AND SPORTS MEDICINE |
| Practice Address |
875 Swift Blvd Richland WA 99352-3592 |
| Mailing Address |
805 Madison St Suite 901 Seattle WA 98104-1172 |
| Practice Telephone | 5099461654 |
| Practice Fax Number | 5099435652 |
| Mailing Telephone | 2062648100 |
| Mailing Fax Number | 2062648689 |
| Enumeration Date | 2011-11-10 |
| Last Update Date | 2011-12-09 |
| 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 | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | L & I | 0287402 | 01 |
| Other Name | Type Code |
|---|---|
| Northwest Orthopaedic and Sports Medicine | 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 |
875 SWIFT BLVD |
| City | RICHLAND |
| State | WA |
| Zip Code | 99352-3592 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497736961 | Mary Lynn Scovazzo | Orthopaedic Surgery | 875 Swift Blvd, Richland, WA 99352-3592 | 2005-11-10 |
| 1720519887 | Leticia Leal | Physical Therapist | 875 Swift Blvd, Richland, WA 99352-3592 | 2017-03-21 |
| 1881125946 | Daniel Mccook | Physical Therapist | 875 Swift Blvd, Richland, WA 99352-3592 | 2017-03-21 |
| 1629519236 | Caitlyn Mccartney | Physical Therapist | 875 Swift Blvd, Richland, WA 99352 | 2017-03-15 |
| 1396284709 | Matthew Kent Porter | Physician Assistant | 875 Swift Blvd, Richland, WA 99352 | 2017-02-17 |
| 1467898577 | Ashley M Lineberry | Physical Therapist | 875 Swift Blvd, Richland, WA 99352 | 2013-05-15 |
| 1518250554 | Timothy Robert Nickolaus | Physician Assistant | 875 Swift Blvd, Richland, WA 99352-3592 | 2011-05-24 |
| 1225327364 | Jason Ryan Dutton | Orthopaedic Surgery | 875 Swift Blvd, Richland, WA 99352 | 2011-03-29 |
| 1982900767 | Amy L Busfield | Physical Therapist | 875 Swift Blvd, Richland, WA 99352 | 2011-01-27 |
| 1114247418 | Keyna Carpenter | Physical Therapist | 875 Swift Blvd, Richland, WA 99352-3592 | 2010-06-09 |
| Find all providers in the same location | ||||
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|---|---|---|---|---|
| 1326683053 | Thrive On Counseling, LLC | Counselor | 718 Jadwin Avenue, Richland, WA 99352 | 2019-11-18 |
| 1225687650 | Tri-cities Marital and Family Therapy | Marriage & Family Therapist | 925 Stevens Dr., Suite 3a, Richland, WA 99352 | 2019-09-09 |
| 1053966754 | Darla Nicole Carpenter-sams | Social Worker | 845 Stevens Suite 3a, Richland, WA 99352 | 2019-08-08 |
| 1538720735 | Compass Home Health Care | Home Health | 4281 Tigar Lane, Richland, WA 99352 | 2019-06-27 |
| 1164089934 | Tri-city Orthodontics, LLC | Dentist | 3200 Duportail St, Ste 203, Richland, WA 99352 | 2019-05-28 |
| 1760956361 | Behavior Treatment Solutions LLC | Behavioral Analyst | 403 Adams St, Richland, WA 99352 | 2019-01-16 |
| 1528566981 | Rxltc, Pllc | Pharmacy | 969 Stevens Dr Ste 1b, Richland, WA 99352 | 2018-01-31 |
| 1154829992 | Jason Brody Anderson | Registered Nurse | 888 Swift Blvd # 180, Richland, WA 99352 | 2018-01-26 |
| 1093247355 | Anderson Mcgilliard | Physical Therapist | 875 Gage Blvd, Richland, WA 99352 | 2017-03-28 |
| 1871042689 | Jennifer Bramhall | Nurse Practitioner | 1100 Goethals Drive Suite F, Kadlec Inland Cardiology, Richland, WA 99352 | 2016-09-22 |
| Find all providers in zip 99352 | ||||
| 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 |
|---|---|---|---|---|
| 1366797037 | Chad Garth Williams | Orthopaedic Surgery | 875 Swift Blvd Ste A, Richland, WA 99352 | 2012-07-19 |
| 1407934896 | David John Gibbons | Orthopaedic Surgery | 1351 Fowler Street, Richland, WA 99352 | 2006-11-01 |
| 1518986884 | Walter J Hales | Orthopaedic Surgery | 821 Swift Boulevard, Richland, WA 99352-7623 | 2006-07-18 |
| 1588689392 | James R Hazel | Orthopaedic Surgery | 821 Swift Blvd, Richland, WA 99352-7623 | 2006-07-13 |
| 1548241029 | Gordon Henry Hsieh | Orthopaedic Surgery | 845 Swift Blvd, Richland, WA 99352 | 2005-11-10 |
| 1497736961 | Mary Lynn Scovazzo | Orthopaedic Surgery | 875 Swift Blvd, Richland, WA 99352-3592 | 2005-11-10 |
| 1326481797 | Gregory L Scallon | Orthopaedic Surgery | 1351 Fowler St, Richland, WA 99352 | 2013-04-16 |
| 1740561745 | Tri-city Orthopaedic Clinic, Psc | Orthopaedic Surgery | 965 Goethals Dr, Richland, WA 99352-3527 | 2011-09-02 |
| 1851680664 | Association of Chmc and University Physicians | Orthopaedic Surgery | 969 Stevens Dr, Suite 1b, Richland, WA 99352-3525 | 2011-04-01 |
| 1225327364 | Jason Ryan Dutton | Orthopaedic Surgery | 875 Swift Blvd, Richland, WA 99352 | 2011-03-29 |
| Find all providers in RICHLAND | ||||
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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.