PROLIANCE SURGEONS, INC., P.S. (NPI# 1841568946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841568946 |
| Entity Type | Organization |
| Organization Name | PROLIANCE SURGEONS, INC., P.S. |
| Other Organization Name | VITREORETINAL ASSOCIATES OF WASHINGTON |
| Practice Address |
1750 112th Ave Ne Ste D050 Bellevue WA 98004 |
| Mailing Address |
805 Madison St Suite 901 Seattle WA 98104-1172 |
| Practice Telephone | 2062153850 |
| Practice Fax Number | 2062153870 |
| Mailing Telephone | 2062648100 |
| Mailing Fax Number | 2062648689 |
| Enumeration Date | 2011-12-05 |
| Last Update Date | 2018-08-30 |
| 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 | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
601484763 | WA | Allopathic & Osteopathic Physicians |
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
601484763 | WA | Ambulatory Health Care Facilities |
| Y | 207W00000X | Ophthalmology | 601484763 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2016220 | 05 | |
| WA | LABOR & INDUSTRIES | 288391 | 01 |
| Other Name | Type Code |
|---|---|
| Proliance Retina | Doing Business As Name - Organization |
| Vitreoretinal Associates of Washington | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1229 Madison St Ste 620, Seattle, WA 981043304 | 2062153850 | 2062153870 |
| 1229 Madison St Ste 680, Seattle, WA 981043541 | 2062153850 | 2062153870 |
| 215 E George Hopper Rd, Burlington, WA 982333105 | 2062153850 | 2062153870 |
| 2205 W Dolarway Rd Ste 2, Ellensburg, WA 989268241 | 2062153850 | 2062153870 |
| 3105 Old Fairhaven Pkwy Ste 103, Bellingham, WA 982258212 | 2062153850 | 2062153870 |
| 321 Ramsay Way Ste 107, Kent, WA 980324544 | 2062153850 | 2062153870 |
| 6100 219th St Sw Ste 280, Mountlake Terrace, WA 980432222 | 2062153850 | 2062153870 |
| 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 |
1750 112TH AVE NE STE D050 |
| City | BELLEVUE |
| State | WA |
| Zip Code | 98004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003103565 | Stefany Jeneifer Cameron | Physician Assistant | 1750 112th Ave Ne Ste D050, Bellevue, WA 98004 | 2011-07-06 |
| 1306312392 | Laurena Diane Richardson | Physician Assistant | 1750 112th Ave Ne Ste D050, Bellevue, WA 98004-3779 | 2018-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306458328 | Geneva Paula Hoskins-dorsey | Nurse Practitioner | 11120 Ne 33rd Place, Suite 202, Bellevue, WA 98004 | 2020-08-20 |
| 1720553613 | Christine Eyler | Pediatrics | Bellevue Pediatrics, C & C Medical Associates, 1940 116th Ave Ne, Ste 200, Bellevue, WA 98004 | 2018-10-08 |
| 1437634730 | Hazelden Betty Ford Foundation | Clinic/Center | 1231 116th Ave. Ne Suite 410, Bellevue, WA 98004 | 2018-10-02 |
| 1356827828 | Seattle Spine Group, Pllc | Orthopaedic Surgery | 1220 116th Ave Ne Ste 102, Bellevue, WA 98004 | 2018-07-17 |
| 1669989216 | Atsuko Nakajima | Acupuncturist | 2223 112th Ave. Ne, Ste 201, Bellevue, WA 98004 | 2018-01-04 |
| 1740794718 | Radka Chapin Counseling, LLC | Clinic/Center | 1611 116th Ave Ne Ste 119, Bellevue, WA 98004 | 2017-11-28 |
| 1962912105 | Cuyler Ann Simmons | Counselor | 3805 108th Ave Ne Ste 204, Bellevue, WA 98004 | 2017-10-02 |
| 1639690357 | Nicolas Lopez-montalvo | Behavioral Analyst | 3003 Northup Way Suite 200, Bellevue, WA 98004 | 2017-07-03 |
| 1124579537 | Matthew Thomas Haley | Pharmacist | 107 Bellevue Way, Se, Bellevue, WA 98004 | 2016-10-20 |
| 1649727348 | Kelsey Tanaka | Nurse Practitioner | 400- 108th Ave Ne, Suite 100, Bellevue, WA 98004 | 2016-09-10 |
| Find all providers in zip 98004 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| 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 Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114212750 | Ernesto Datoc Golez IIi | Ophthalmology | 1920 116th Avenue Northeast, Bellevue, WA 98004-3218 | 2011-06-11 |
| 1649457326 | Kenneth Laurence Morton | Ophthalmology | 14655 Bel Red Rd Ste 203, Bellevue, WA 98007-3900 | 2008-01-24 |
| 1891818035 | Matthew Richard Sharpe | Ophthalmology | 2285 116th Ave Ne, Bellevue, WA 98004-3041 | 2007-04-10 |
| 1588779201 | James Joseph Mcmillan | Ophthalmology | 136 102nd Ave Se Ste 102b, Bellevue, WA 98004-8135 | 2006-08-21 |
| 1083659262 | Kristin J Tarbet | Ophthalmology | 1810 116th Ave Ne Ste D1, Bellevue, WA 98004-3058 | 2006-06-19 |
| 1346206224 | Howard S Barnebey | Ophthalmology | 1920 116th Ave Ne, Bellevue, WA 98004-3019 | 2006-04-21 |
| 1134104094 | Michael Rizen | Ophthalmology | 1300 116th Ave Ne, Bellevue, WA 98004-3820 | 2005-12-13 |
| 1467459420 | Craig G Wells | Ophthalmology | 1750 112th Ave Ne, Sutie D050, Bellevue, WA 98004-3752 | 2005-07-06 |
| 1528062320 | Kent G Leavitt | Ophthalmology | 1135 116th Ave Ne Ste 450, Bellevue, WA 98004-4623 | 2005-06-09 |
| 1255961918 | N W Eye Surgeons P C | Ophthalmology | 1810 116th Ave Ne Ste D1, Bellevue, WA 98004-3058 | 2020-01-22 |
| Find all providers in BELLEVUE | ||||
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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.