Proliance Surgeons, Inc., P.S.

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

PROLIANCE SURGEONS, INC., P.S.

Doing business as

Proliance Surgeons Skagit Northwest Orthopedics
Proliance Surgeons Skagit Northwest Physical Therapy

Practice address

1401 S Laventure Rd
Mount Vernon, WA 98274-6033

Phone

(360) 424-2400

Fax

(360) 424-2418

NPI assigned

Jun 14, 2006

Last updated

Jun 24, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cori M. Pleasant

Title

MGR Provider Relations/Enrollment

Phone

(206) 838-2585

Specialties & licenses 6

Addresses

Other identifiers 3

Other names 2

• Proliance Surgeons Skagit Northwest Orthopedics Doing business as
• Proliance Surgeons Skagit Northwest Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William Brandt Bede, M.D.

  • Orthopaedic Surgery Physician
  • Lakewood, WA
  • NPI 1720057094
  NPD
• Cindy Elise Bullock, DPM

  • Podiatrist
  • Mount Vernon, WA
  • NPI 1598770927
  NPD
• Kathryn Buck Chapman, DPT

  • Physical Therapist
  • Anacortes, WA
  • NPI 1699443960
  NPD
• Jimmy Yi Cui, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Mount Vernon, WA
  • NPI 1720057342
  NPD
• Breanna Lynn Emrick, PA-C

  • Surgical Physician Assistant
  • Tacoma, WA
  • NPI 1942725072
  NPD
• Daniel M Hanesworth, M.D.

  • Orthopaedic Surgery Physician
  • Mount Vernon, WA
  • NPI 1619946910
  NPD
• John J Jiganti, MD

  • Orthopaedic Surgery Physician
  • Lakewood, WA
  • NPI 1609842673
  NPD
• Rafael A. Lara, P.T.

  • Physical Therapist
  • Bellingham, WA
  • NPI 1730403973
  NPD
• Leslie Martinez, PA-C

  • Surgical Physician Assistant
  • Tacoma, WA
  • NPI 1588454656
  NPD
• John David McGowan, MD

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1962480897
  NPD
• Timothy Ellis Messmer, D.P.M.

  • Podiatrist
  • Mount Vernon, WA
  • NPI 1477552701
  NPD
• David Michael Mourning, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Mount Vernon, WA
  • NPI 1033150420
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719187200000",
    "number": "1023051489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S LAVENTURE RD",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982746033",
            "telephone_number": "360-424-7041",
            "fax_number": "360-424-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S LAVENTURE RD",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982746033",
            "telephone_number": "360-424-2400",
            "fax_number": "360-424-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLIANCE SURGEONS, INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A",
        "authorized_official_last_name": "PLEASANT",
        "authorized_official_first_name": "CORI",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "MGR PROVIDER RELATIONS/ENROLLMENT",
        "authorized_official_telephone_number": "206-838-2585"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "601484763",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "601484763",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "601484763",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "601484763",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1042545",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "05327-00015",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LABOR & INDUSTRIES",
            "identifier": "121724",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Proliance Surgeons Skagit Northwest Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Proliance Surgeons Skagit Northwest Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Proliance Surgeons Skagit Northwest Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Barbara H Pringle, MD
• Robert W Pringle, MD
• Private Healthcare Facilities
• Pro Care Medical Group (Health Med Centers)
• Proliance Surgeons Inc P S (Proliance Skagit Northwest Orthopedic Surgery Center)
• Proliance Surgeons, Inc., P.S. (Skagit Northwest Orthopedics MRI)
• Proliance Surgeons, Inc., P.S. (Cascade Ear Nose and Throat)
• Proliance Surgeons, Inc., P.S. (Skagit Northwest Orthopedics ASC at Continental)
• Proliance Surgeons, Inc., P.S. (Proliance Surgeons Skagit Northwest Orthopedics/Physical Therapy)
• Proliance Surgeons, Inc., P.S. (Cascade Ear Nose and Throat Surgery Center)

• Multi-Specialty Clinic/Center in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Multi-Specialty Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.