PROLIANCE SURGEONS, INC., P.S (NPI# 1063924116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063924116 |
Entity Type | Organization |
Organization Name | PROLIANCE SURGEONS, INC., P.S |
Other Organization Name | SEATTLE NEURO & SPINE SURGERY |
Practice Address |
801 Broadway Ste 617 Seattle WA 98122-4319 |
Mailing Address |
805 Madison St Ste 901 Seattle WA 98104-1172 |
Practice Telephone | 2066230922 |
Practice Fax Number | 2066231588 |
Mailing Telephone | 2062648100 |
Enumeration Date | 2017-10-30 |
Last Update Date | 2020-01-23 |
Authorized Official Name | MR. KENNETH OVERBEY (COO) |
Authorized Official Telephone | 2068382583 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
Allopathic & Osteopathic Physicians | ||
N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers | ||
Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WA | OWCP | 629157500 | 01 |
WA | WA LABOR & INDUSTRIES | 383896 | 01 |
WA | 2094729 | 05 |
Other Name | Type Code |
---|---|
Seattle Neuro & Spine Surgery | Doing Business As Name - Organization |
Seattle Neurosurgery | Doing Business As Name - Organization |
Address | Telephone Number | Fax Number |
---|---|---|
1607 Cooper Point Rd Nw, Olympia, WA 985028325 | 2066230922 | 2066231588 |
751 Ne Blakely Dr Ste 4020, Issaquah, WA 980296201 | 2066230922 | 2066231588 |
20700 Bond Rd Ne Ste 105, Poulsbo, WA 983709099 | 2066230922 | 2066231588 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326564790 | Proliance Surgeons, Inc., P.s | Orthopaedic Surgery | 6808 220th St Sw Ste 200, Mountlake Terrace, WA 98043-2187 | 2017-08-17 |
1659871622 | Proliance Surgeons, Inc., P.s | Podiatrist | 7320 216th St Sw Ste 320b, Edmonds, WA 98026-8006 | 2018-02-16 |
1649445420 | Proliance Surgeons, Inc., P.s | Otolaryngology | 9730 3rd Ave Ne, Suite 201, Seattle, WA 98115-2023 | 2008-04-23 |
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 |
801 BROADWAY STE 617 |
City | SEATTLE |
State | WA |
Zip Code | 98122-4319 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598733172 | Glen M. Rogers | Physician Assistant | 801 Broadway Ste 617, Seattle, WA 98122-4319 | 2006-03-09 |
1124628359 | Lydia Katherine Mcclaran | Physician Assistant | 801 Broadway Ste 617, Seattle, WA 98122-4319 | 2020-10-27 |
1679663488 | Todd P Kreps | Physician Assistant | 801 Broadway Ste 617, Seattle, WA 98122-4319 | 2006-10-13 |
1023087780 | Jeffrey L Garr | Orthopaedic Surgery | 801 Broadway Ste 617, Seattle, WA 98122-4319 | 2006-03-15 |
1407825292 | Alexis Falicov | Orthopaedic Surgery | 801 Broadway Ste 617, Seattle, WA 98122-4319 | 2006-03-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053938506 | Quality Counseling and Consultation Service LLC | Counselor | 1525 Harvard Ave #509, Seattle, WA 98122 | 2020-07-01 |
1912535626 | Cesar Andrade | Student in an Organized Health Care Education/Training Program | 550 16th Avenue #400, Seattle, WA 98122 | 2020-03-29 |
1366089666 | Peter Nguyen | Pharmacy Technician | 914 East Jefferson Street, Campion Hall, Seattle, WA 98122 | 2019-12-05 |
1356903140 | Jason Dandino | Specialist/Technologist | 550 14th Avenue, Seattle, WA 98122 | 2019-07-02 |
1962066415 | Seattle Colleges | Local Education Agency (LEA) | Mainstay At Seattle Central College, 1701 Broadway Ms Be3210, Seattle, WA 98122 | 2019-04-30 |
1538621412 | Mitchell R Ornelas | Student in an Organized Health Care Education/Training Program | Swedish Family Medicine Residency Cherry Hill; 550 16th, Avenue #400, Seattle, WA 98122 | 2019-04-01 |
1003374265 | Michael Russell | Surgery | 747 Broadway Heath Building 10th Floor, Seattle, WA 98122 | 2019-03-06 |
1639646821 | Maritza E Cajiao | Doula | 747 Broadway, Seattle, Seattle, WA 98122 | 2018-10-25 |
1336616762 | Suzanna M Lovin | Social Worker | 401 Broadway, 1st Floor, Seattle, WA 98122 | 2018-10-24 |
1184137770 | Walter Franklin Krengel Jr. | Orthopaedic Surgery | 2000 1st Ave Suite 2201, Seattle, WA 98122 | 2017-11-06 |
Find all providers in zip 98122 |
Taxonomy Code | 207T00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Neurological Surgery |
A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891243820 | Kiana Uylukcu | Neurological Surgery | Medex Northwest, 4311 11th Avenue Ne, Suite 200, Seattle, WA 98105-3007 | 2016-09-19 |
1659618510 | Antonio A Moure | Neurological Surgery | 1521 2nd Ave, Apartment 1400, Seattle, WA 98101-4500 | 2013-01-12 |
1699033894 | Calvin Curtis Whaley | Neurological Surgery | 550 17th Ave Ste 110, Seattle, WA 98122-5789 | 2012-04-25 |
1285822197 | Amir Kershenovich Rabinovitz | Neurological Surgery | 401 Broadway E # 2075, Seattle, WA 98102-5021 | 2007-10-05 |
1972710044 | Rod J Oskouian Jr. | Neurological Surgery | Seattle Neuroscience Specialists, 550 1th Ave 5th Floor, Seattle, WA 98122-5788 | 2007-05-17 |
1659594083 | William R. Miele | Neurological Surgery | 125 16th Ave E Fl 3, Seattle, WA 98112-5211 | 2007-04-11 |
1285756304 | Jean-christophe Andre Leveque | Neurological Surgery | 1100 Ninth Ave, Dept of Neurosugery X7-ns, Seattle, WA 98101 | 2007-04-06 |
1013074558 | Trent Lane Tredway | Neurological Surgery | 737 Olive Way Apt 2502, Seattle, WA 98101-3751 | 2007-01-03 |
1710046511 | Marc R Mayberg | Neurological Surgery | 1959 Ne Pacific St Box 356165, Seattle, WA 98195-5788 | 2006-12-07 |
1164581054 | David W Newell | Neurological Surgery | 550 17th Ave Ste 240, Seattle, WA 98122-5877 | 2006-12-06 |
Find all providers in SEATTLE |
Please comment or provide details below to improve the information on PROLIANCE SURGEONS, INC., P.S.
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.