PROVASCULAR SURGERY ASSOCIATES PLLC (NPI# 1174851810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174851810 |
| Entity Type | Organization |
| Organization Name | PROVASCULAR SURGERY ASSOCIATES PLLC |
| Practice Address |
4300 Talbot Rd S Ste 101 Renton WA 98055-6328 |
| Mailing Address |
4300 Talbot Rd S Ste 101 Renton WA 98055-6238 |
| Practice Telephone | 4252274341 |
| Practice Fax Number | 4257936045 |
| Mailing Telephone | 4252274341 |
| Mailing Fax Number | 4257936045 |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2014-12-12 |
| Authorized Official Name | DENNIS L SU (PHYSICIAN/OWNER) |
| Authorized Official Telephone | 4252274341 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
MD60106870 | WA | Allopathic & Osteopathic Physicians |
| Street Address |
4300 TALBOT RD S STE 101 |
| City | RENTON |
| State | WA |
| Zip Code | 98055-6328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770581910 | Mark Thomas Lewis | Podiatrist | 4300 Talbot Rd S, Suite 102, Renton, WA 98055-6238 | 2005-07-12 |
| 1013553841 | Vanessa Marie Rawlings | Nurse Practitioner | 4300 Talbot Rd S, Renton, WA 98055-6238 | 2019-11-27 |
| 1528430030 | Leah C Spellen | Naturopath | 4300 Talbot Rd S, 402, Renton, WA 98055-6238 | 2015-10-23 |
| 1932502234 | Yariel Bello | Massage Therapist | 4300 Talbot Rd S, Suite 303, Renton, WA 98055-6238 | 2014-09-30 |
| 1154699742 | Nw Treatment Center LLC | Massage Therapist | 4300 Talbot Rd S, Ste 303, Renton, WA 98055-6238 | 2011-12-09 |
| 1174823496 | Jamie Lynn Wilcox | Midwife | 4300 Talbot Rd S, Suite 402, Renton, WA 98055-6238 | 2010-11-02 |
| 1619289667 | Marcus R Kauffman, M.d., Pllc | Urology | 4300 Talbot Rd S, Suite 104, Renton, WA 98055-6238 | 2010-07-07 |
| 1952624009 | Pain and Wellness Nw Pllc | Specialist | 4300 Talbot Rd S, Ste 200, Renton, WA 98055-6238 | 2010-03-03 |
| 1649403866 | Dennis Lien-hsun Su | Surgery | 4300 Talbot Rd S, Suite 101, Renton, WA 98055-6238 | 2009-09-03 |
| 1720210982 | Diana Kraemer Md Pllc | Specialist | 4300 Talbot Rd S, Suite 315, Renton, WA 98055-6238 | 2009-08-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356965750 | Proliance Surgery Center At Valley, LLC | Clinic/Center | 4009 Talbot Road S, Suite 200, Renton, WA 98055 | 2020-06-01 |
| 1851804959 | Talbot Rehabilitation Center, LLC | Skilled Nursing Facility | 4430 Talbot Road South, Renton, WA 98055 | 2017-11-10 |
| 1154878668 | Nelson Family Dentistry | Dentist | 19221 108th Ave Se Suite #2, Renton, WA 98055 | 2016-09-01 |
| 1598182990 | Annie Kyunga Ahn | Otolaryngology | 4033 Talbot Rd S Ste 540, Renton, WA 98055 | 2014-03-24 |
| 1376960138 | Madhuri Gordhan Patel | Registered Nurse | 3501 Mill Place South, Renton, WA 98055 | 2014-03-18 |
| 1912331042 | Karen Dohr | Pharmacist | 400 S. 43 Street, Renton, WA 98055 | 2013-08-26 |
| 1659637668 | Benjamin Reiss | Ophthalmology | 4300 Talbot Rd S Ste 300, Renton, WA 98055 | 2012-04-03 |
| 1205137940 | Duy Ai Quang Hoang | Pharmacist | 9431 S 196th Pl, Renton, WA 98055 | 2010-11-11 |
| 1972823664 | Erica L Ellzey | Physical Therapist | 18623 112th Ave Se, Renton, WA 98055 | 2010-06-04 |
| 1588984587 | Melissa A. Jordan | Nurse Anesthetist, Certified Registered | 4011 Talbot Rd., 5th Floor, Renton, WA 98055 | 2010-06-02 |
| Find all providers in zip 98055 | ||||
| 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 |
|---|---|---|---|---|
| 1285958967 | Donald Gilbert Harris | Surgery | 4033 Talbot Rd S Ste 530, Renton, WA 98055-5700 | 2010-03-24 |
| 1649403866 | Dennis Lien-hsun Su | Surgery | 4300 Talbot Rd S, Suite 101, Renton, WA 98055-6238 | 2009-09-03 |
| 1689865032 | Franciscan Health System | Surgery | 4033 Talbot Rd S, Ste 430, Renton, WA 98055-5772 | 2007-08-09 |
| 1639288541 | Sherene N Shalhub | Surgery | 400 S 43rd St, Renton, WA 98055-5714 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710496922 | Sunnyside Community Hospital Association | Surgery | 1005 W Walnut St Ste 201, Yakima, WA 98902-3384 | 2017-09-20 |
| 1750762415 | Anna Ohlsson | Surgery | 325 9th Ave # 359908, Seattle, WA 98104-2420 | 2015-06-17 |
| 1356722938 | Usa Vascular Centers of Kent Pllc | Surgery | 26124a Pacific Hwy S Ste A, Kent, WA 98032-6910 | 2015-06-09 |
| 1154602084 | Memorial Physicians, Pllc | Surgery | 1812 E Edison Ave, Sunnyside, WA 98944-1653 | 2011-09-06 |
| 1528387941 | Sara Jane Wasilenko | Surgery | 128 Lilly Rd Ne Ste 205, Olympia, WA 98506-7400 | 2010-05-25 |
| 1801051404 | Franciscan Medical Group | Surgery | 710 S 348th St, Ste A, Federal Way, WA 98003-7042 | 2008-07-23 |
| 1013104165 | John S Arthur | Surgery | 2528 Wheaton Way Ste 101, Bremerton, WA 98310-3305 | 2007-10-02 |
| 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 |
| 1649491481 | Dae Young Lee | Surgery | 1100 Goethals Drive 3rd Floor, Kadlec Clinic Vascular Surgery, Richland, WA 99352-3304 | 2007-05-01 |
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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.