PROLIANCE SURGEONS, INC., P.S. (NPI# 1164461182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164461182 |
| Entity Type | Organization |
| Organization Name | PROLIANCE SURGEONS, INC., P.S. |
| Other Organization Name | PROLIANCE EASTSIDE MRI |
| Practice Address |
12911 120th Ave Ne Suite H-120 Kirkland WA 98034-3027 |
| Mailing Address |
12911 120th Ave Ne Ste G10 Kirkland WA 98034-3048 |
| Practice Telephone | 4258234226 |
| Practice Fax Number | 4258234754 |
| Mailing Telephone | 4254816301 |
| 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 | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities | ||
| 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 | ||
| Y | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Proliance Eastside MRI | 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 |
12911 120TH AVE NE SUITE H-120 |
| City | KIRKLAND |
| State | WA |
| Zip Code | 98034-3027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235125188 | Aileen Ann Mickey | Internal Medicine | 12911 120th Ave Ne, Evergreen Pulmonary Care Center, Suite G-105, Kirkland, WA 98034-3027 | 2005-09-26 |
| 1912459652 | Cascade Natural Medicine | Naturopath | 12911 120th Ave Ne, Suite E-50, Kirkland, WA 98034-3027 | 2016-10-28 |
| 1306396338 | Clark Anthony Laprelle II | Physician Assistant | 12911 120th Ave Ne, Suite H-210, Kirkland, WA 98034-3027 | 2016-10-14 |
| 1457726143 | Chapin Densmore,dds, Ps | Dentist | 12911 120th Ave Ne, Suite D 50, Kirkland, WA 98034-3027 | 2015-12-06 |
| 1316340706 | Krystal Plonski | Naturopath | 12911 120th Ave Ne, Suite E-50, Kirkland, WA 98034-3027 | 2014-09-30 |
| 1114334612 | Rx Digital Radiology, LLC | Radiology | 12911 120th Ave Ne, F-240, Kirkland, WA 98034-3027 | 2014-07-16 |
| 1417360124 | Chapin Densmore | Dentist | 12911 120th Ave Ne, Suite D50, Kirkland, WA 98034-3027 | 2014-06-10 |
| 1265776470 | Garrett D. Gray | Physician Assistant | 12911 120th Ave Ne, Suite H-210, Kirkland, WA 98034-3027 | 2012-11-12 |
| 1427300565 | Sarah Severance Goble | Physician Assistant | 12911 120th Ave Ne, Suite H-210, Kirkland, WA 98034-3027 | 2012-10-14 |
| 1205194982 | Integrated Rehab Group Limited Partnership | Occupational Therapist | 12911 120th Ave Ne, #f120, Kirkland, WA 98034-3027 | 2012-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578116596 | Rachel Bowers | Behavior Technician | 1335 Northeast 122nd Way, Suite 105, Kirkland, WA 98034 | 2019-07-18 |
| 1740841048 | Kristina Louise Inghram | Behavior Technician | 11415 Ne 128th St., Suite 40, Kirkland, WA 98034 | 2019-06-26 |
| 1053978064 | Matthew A. Bagnulo, Dds, Ps | Dentist | 11830 Ne 128th St., #202, Kirkland, WA 98034 | 2019-05-24 |
| 1629568928 | Stephanie Michalko | Optometrist | 11800 Ne 128th St Ste 110, Kirkland, WA 98034 | 2018-05-14 |
| 1952800013 | Heath Family Counseling LLC | Marriage & Family Therapist | 12025 115th Ave. Ne, Building D, Ste 200, Kirkland, WA 98034 | 2018-02-05 |
| 1891202834 | Barbara Josephine Gorham | Counselor | 2025 115th Ave Ne, Bldg D, #200, Kirkland, WA 98034 | 2017-12-29 |
| 1548782915 | Eleanor Hollis Wall | Counselor | 14340 102nd Ave Ne, Kirkland, WA 98034 | 2017-07-07 |
| 1457885212 | Peter Schoonmaker | Hospitalist | 12040 Ne 128th Street, Ms105, Kirkland, WA 98034 | 2017-04-18 |
| 1780124370 | Rebecca Managan | Advanced Practice Midwife | 12303 Ne 130th Ln Ste Coral225, Kirkland, WA 98034 | 2017-03-01 |
| 1669821104 | Winter Gonzalez | Counselor | 11720 97th Ln Ne Apt A411, Kirkland, WA 98034 | 2016-06-06 |
| Find all providers in zip 98034 | ||||
| Taxonomy Code | 261QM1200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Magnetic Resonance Imaging (MRI) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982653952 | Capital Imaging LLC | Clinic/Center | 220 Sw 43rd St, Renton, WA 98055-4936 | 2006-05-08 |
| 1952399123 | Proliance Surgeons, Inc., P.s. | Clinic/Center | 3801 5th St Se, Suite 110, Puyallup, WA 98374-2106 | 2005-10-11 |
| 1710980511 | Open Mri of Federal Way, L.L.C. | Clinic/Center | 33301 9th Ave S, Ste 105, Federal Way, WA 98003-2600 | 2005-05-24 |
| 1588899173 | Dynamic Medical Diagnostic Imaging Centers, LLC | Clinic/Center | 5038 Tacoma Mall Blvd, Suite C, Tacoma, WA 98409-7103 | 2009-05-26 |
| 1891946257 | Olympia Neurology, Pllc | Clinic/Center | 128 Lilly Rd Ne, Suite 101, Olympia, WA 98506-7400 | 2008-10-03 |
| 1619127206 | Olympia Orthopaedic Associates, Pllc | Clinic/Center | 3901 Capital Mall Dr Sw, Ste C, Olympia, WA 98502-8654 | 2008-09-19 |
| 1174799282 | South Sound Neurosurgery Pllc | Clinic/Center | 1519 3rd St Se, Suite 103, Puyallup, WA 98372-3742 | 2008-05-08 |
| 1467666701 | Objective Diagnostics & Research Ps | Clinic/Center | 4803 Center St, Tacoma, WA 98409-2319 | 2007-05-09 |
| 1013071877 | Cascade Imaging Associates L.L.C. | Clinic/Center | 1415 E Kincaid St, Mount Vernon, WA 98274-4126 | 2006-12-19 |
| 1932262904 | Proliance Surgeons, Inc., P.s. | Clinic/Center | 27005 168th Pl Se, Suite 201, Covington, WA 98042-4902 | 2006-12-19 |
| Find all providers with the same taxonomy | ||||
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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.