PROLIANCE SURGEONS INC., P.S. (NPI# 1417990797) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417990797 |
| Entity Type | Organization |
| Organization Name | PROLIANCE SURGEONS INC., P.S. |
| Other Organization Name | PROLIANCE ORTHOPEDIC ASSOCIATES |
| Practice Address |
4011 Talbot Rd S Suite 300 Renton WA 98055-5773 |
| Mailing Address |
4011 Talbot Rd S Ste 300 Renton WA 98055-5791 |
| Practice Telephone | 4256565060 |
| Practice Fax Number | 4256565047 |
| Mailing Telephone | 4256565060 |
| Mailing Fax Number | 4256565047 |
| Enumeration Date | 2006-06-14 |
| 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 | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
601484763 | WA | Allopathic & Osteopathic Physicians |
| N | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
601484763 | WA | Allopathic & Osteopathic Physicians |
| N | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
601484763 | WA | Allopathic & Osteopathic Physicians |
| N | 2083X0100X |
Preventive Medicine Specialization: Occupational Medicine |
601484763 | WA | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
Ambulatory Health Care Facilities | ||
| N | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities | ||
| N | 2471M1202X |
Radiologic Technologist Specialization: Magnetic Resonance Imaging |
601484763 | WA | Technologists, Technicians & Other Technical Service Providers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 207X00000X | Orthopaedic Surgery | 601484763 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | WA L&I | 49370 | 01 |
| WA | DME | 0532700025 | 01 |
| Other Name | Type Code |
|---|---|
| Proliance Orthopedic Associates | Doing Business As Name - Organization |
| Proliance Orthopedic Associates MRI | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8009 S 180th St Ste 105, Kent, WA 980321042 | 4256560711 | 4256560344 |
| 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 |
| 1821031113 | Proliance Surgeons Inc., P.s. | Surgery | 16122 8th Ave Sw, D-1, Burien, WA 98166-2967 | 2006-06-14 |
| 1134169931 | Proliance Surgeons Inc., P.s. | Surgery | 1600 E Jefferson St, Suite 101, Seattle, WA 98122-5698 | 2006-06-08 |
| Street Address |
4011 TALBOT RD S SUITE 300 |
| City | RENTON |
| State | WA |
| Zip Code | 98055-5773 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528061694 | Guy V Buell | Specialist | 4011 Talbot Rd S, Ste 440, Renton, WA 98055-5791 | 2005-05-23 |
| 1649756883 | Amy Elizabeth Hardiman | Physical Therapy Assistant | 4011 Talbot Rd S, Renton, WA 98055-5773 | 2018-07-11 |
| 1336665959 | Mary Elizabeth Walton | Dietitian, Registered | 4011 Talbot Rd S, Renton, WA 98055-5773 | 2017-08-15 |
| 1548791924 | Southlake Select, PC | Point of Service | 4011 Talbot Rd S, 440, Renton, WA 98055-5773 | 2017-03-27 |
| 1871031864 | Abrey Lee | Dietitian, Registered | 4011 Talbot Rd S, Suite 100, Renton, WA 98055-5773 | 2017-02-09 |
| 1962940957 | Kimberly Diana Konczak | Dietitian, Registered | 4011 Talbot Rd S, Suite 100, Renton, WA 98055-5773 | 2017-02-09 |
| 1578931325 | Andrew S Huntley | Physician Assistant | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2015-09-10 |
| 1285011080 | Anne Macleod | Registered Nurse | 4011 Talbot Rd S, Renton, WA 98055-5773 | 2015-04-30 |
| 1508263716 | Mie Hagiwara | Physician Assistant | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2014-12-03 |
| 1073921813 | Zachary A. Bowman | Physician Assistant | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2014-07-24 |
| 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 | 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 |
|---|---|---|---|---|
| 1487849121 | Lawrence W Snow, Md Inc.ps | Orthopaedic Surgery | 17910 Talbot Rd S Ste 100, Renton, WA 98055-6237 | 2007-09-06 |
| 1568875789 | Proliance Surgeons, Inc., P.s. | Orthopaedic Surgery | 4361 Talbot Rd S, Suite 102, Renton, WA 98055-6226 | 2014-06-05 |
| 1831488550 | Sean Paul Haloman | Orthopaedic Surgery | 4011 Talbot Rd S Ste 300, Renton, WA 98055 | 2011-04-04 |
| 1063725505 | David P Ruoff, Md, Inc, Ps. | Orthopaedic Surgery | 4361 Talbot Rd S, Suite 102, Renton, WA 98055-6226 | 2010-07-26 |
| 1730404286 | Timothy Bruce Alton | Orthopaedic Surgery | 4011 Talbot Rd S Ste 300, Renton, WA 98055-5791 | 2010-03-27 |
| 1487892659 | Donald Dale Hubbard | Orthopaedic Surgery | 17900 Talbot Rd S, Suite 101, Renton, WA 98055-8212 | 2009-01-27 |
| 1720278344 | Andrew L. Merritt | Orthopaedic Surgery | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2007-07-30 |
| 1780705947 | Niket Shrivastava | Orthopaedic Surgery | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2007-04-03 |
| 1174648703 | Erik J Novak | Orthopaedic Surgery | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2007-03-20 |
| 1467562421 | Christopher R Howe | Orthopaedic Surgery | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2006-08-30 |
| Find all providers in RENTON | ||||
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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.