PROLIANCE SURGEONS INC., P.S. (NPI# 1134169931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134169931 |
| Entity Type | Organization |
| Organization Name | PROLIANCE SURGEONS INC., P.S. |
| Other Organization Name | SURGICAL ASSOCIATES OF EDMONDS |
| Practice Address |
1600 E Jefferson St Suite 101 Seattle WA 98122-5698 |
| Mailing Address |
720 Olive Way Suite 1505 Seattle WA 98101-1878 |
| Practice Telephone | 2063280100 |
| Practice Fax Number | 2063202102 |
| Mailing Telephone | 2068382590 |
| Mailing Fax Number | 2062648689 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. DAVID G FITZGERALD (CLAIMS MANAGER) |
| Authorized Official Telephone | 2068382599 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
WA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Surgical Associates of Edmonds | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134165897 | Proliance Surgeons Inc., P.s. | Orthopaedic Surgery | 12911 120th Ave Ne Ste H220, Kirkland, WA 98034-3064 | 2006-06-21 |
| 1467085126 | Proliance Surgeons Inc., P.s. | Physical Therapist | 190 W Dayton St Ste 202, Edmonds, WA 98020-7221 | 2020-02-20 |
| 1083752042 | Proliance Surgeons Inc., P.s. | Occupational Therapist | 510 8th Ave Ne, Suite 340, Issaquah, WA 98029-5436 | 2007-02-02 |
| 1508893066 | Proliance Surgeons Inc., P.s. | Orthopaedic Surgery | 1231 116th Ave Ne, Suite 750, Bellevue, WA 98004-3804 | 2006-06-28 |
| 1073540894 | Proliance Surgeons Inc., P.s. | Surgery | 7315 212th St Sw, Suite 201, Edmonds, WA 98026-7610 | 2006-06-27 |
| 1386687747 | Proliance Surgeons Inc., P.s. | Pain Medicine | 7320 216th St Sw, Suite 320, Edmonds, WA 98026-8006 | 2006-06-14 |
| 1417990888 | Proliance Surgeons Inc., P.s. | Occupational Therapist | 8009 S 180th St, Suite 112, Kent, WA 98032-1042 | 2006-06-14 |
| 1699718973 | Proliance Surgeons Inc., P.s. | Surgery | 1412 Sw 43rd St, Suite 201, Renton, WA 98055-4801 | 2006-06-14 |
| 1417990797 | Proliance Surgeons Inc., P.s. | Internal Medicine | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2006-06-14 |
| 1821031113 | Proliance Surgeons Inc., P.s. | Surgery | 16122 8th Ave Sw, D-1, Burien, WA 98166-2967 | 2006-06-14 |
| Street Address |
1600 E JEFFERSON ST SUITE 101 |
| City | SEATTLE |
| State | WA |
| Zip Code | 98122-5698 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083614861 | Jeffrey T Reiter | Psychologist | 1600 E Jefferson St, Ste 510, Seattle, WA 98122-5698 | 2005-07-22 |
| 1518458678 | Pamela Willingham | Physical Therapist | 1600 E Jefferson St, Seattle, WA 98122 | 2018-05-24 |
| 1740729300 | Mary Henry | Audiologist | 1600 E Jefferson St, Jefferson Tower Suite 205, Seattle, WA 98122-5698 | 2017-02-15 |
| 1326592304 | Jenna Kathryn Bailey | Naturopath | 1600 E Jefferson St, Seattle, WA 98122-5698 | 2016-08-08 |
| 1700236080 | Nathan Allen Coomer | Physical Therapist | 1600 E Jefferson St, Suite A1, Seattle, WA 98122-5698 | 2016-06-16 |
| 1881058832 | Laboratory Corporation of America | Clinical Medical Laboratory | 1600 E Jefferson St, Suite 510, Seattle, WA 98122-5698 | 2016-04-06 |
| 1902277817 | Institute of Complementary Medicine, LLC | Non-Pharmacy Dispensing Site | 1600 E Jefferson St, Suite 603, Seattle, WA 98122-5698 | 2015-10-19 |
| 1417327768 | Simon Gordon Gale | Occupational Therapist | 1600 E Jefferson St, Suite A, Seattle, WA 98122-5698 | 2015-09-29 |
| 1619363074 | Genevieve Catherine Courtney | Naturopath | 1600 E Jefferson St, Suite 603, Seattle, WA 98122-5698 | 2015-04-13 |
| 1619379237 | Erica Jayne Joseph | Acupuncturist | 1600 E Jefferson St, Suite 603, Seattle, WA 98122-5698 | 2014-09-25 |
| Find all providers in the same location | ||||
| 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 | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750762415 | Anna Ohlsson | Surgery | 325 9th Ave # 359908, Seattle, WA 98104-2420 | 2015-06-17 |
| 1891986097 | Vascular Associates, Ps | Surgery | 801 Broadway Ste 522, Seattle, WA 98122-4325 | 2007-08-05 |
| 1447464730 | Mai Thanh Pham | Surgery | 1229 Madison St Suite # 1190, Seattle, WA 98104 | 2007-05-09 |
| 1659480630 | Ellen Lyman Thomason Derrick | Surgery | 3216 Ne 45th Pl Ste 207, Seattle, WA 98105-4028 | 2006-08-30 |
| 1366491045 | Kaj Johansen | Surgery | 600 Broadway Ste 112, Seattle, WA 98122-5381 | 2006-05-09 |
| 1568430908 | Swee Lian Tan | Surgery | 515 Minor Ave Ste 240, Seattle, WA 98104-2133 | 2006-03-10 |
| 1295730018 | Paul Gregory Hayes | Surgery | 801 Broadway Ste 500, Seattle, WA 98122-4396 | 2005-06-17 |
| 1184020307 | Usa Vein Clinics of Seattle, Pllc | Surgery | 10564 5th Ave Ne, Suite 102, Seattle, WA 98125-7200 | 2014-11-16 |
| 1942542212 | Matthew C Smith | Surgery | 1550 N 115th St, Seattle, WA 98133-8401 | 2013-03-25 |
| 1043579600 | Matthew Evans Bennett | Surgery | 1100 9th Ave, Seattle, WA 98101-2756 | 2012-05-16 |
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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.