Proliance Surgeons Inc., P.S.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

PROLIANCE SURGEONS INC., P.S.

Doing business as

Proliance Surgical Specialists of Edmonds

Practice address

7320 216TH St SW Ste 20
Edmonds, WA 98026-8006

Phone

(425) 778-8116

Fax

(425) 775-9526

NPI assigned

Jun 27, 2006

Last updated

Jun 21, 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 1

• Proliance Surgical Specialists of Edmonds Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 24

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.

• Sarah S. Chandler, ARNP, CNM

  • Obstetrics & Gynecology Nurse Practitioner
  • Seattle, WA
  • NPI 1144649310
  NPD
• Carol J Cornejo, M.D.

  • Surgery Physician
  • Edmonds, WA
  • NPI 1316916927
  NPD
• Shelby G Dobbs, PAC

  • Surgical Physician Assistant
  • Bellevue, WA
  • NPI 1184669491
  NPD
• Eric Andrew Eisen, M.D.

  • Otolaryngology Physician
  • Bellevue, WA
  • NPI 1104203793
  NPD
• Diane E Engelbrecht, M.D.

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1275507105
  NPD
• Nicholas Ryan Galloway, MD

  • Diagnostic Radiology Physician
  • Bellevue, WA
  • NPI 1225458839
  NPD
• Garrett D. Gray, PA-C

  • Surgical Physician Assistant
  • Kirkland, WA
  • NPI 1265776470
  NPD
• Kurt E Harmon, M.D.

  • Surgery Physician
  • Edmonds, WA
  • NPI 1780653089
  NPD
• Lori A Hill, PA-C

  • Surgical Physician Assistant
  • Bellevue, WA
  • NPI 1649219700
  NPD
• Judith M Kimelman, MD

  • Obstetrics & Gynecology Physician
  • Seattle, WA
  • NPI 1447222435
  NPD
• Anjali Savithri Kumar, M.D., M.P.H.

  • Colon & Rectal Surgery Physician
  • Yakima, WA
  • NPI 1215189535
  NPD
• Rodrigo Landeros, PA-C

  • Surgical Physician Assistant
  • Edmonds, WA
  • NPI 1902253172
  NPD

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718928000000",
    "number": "1073540894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7320 216TH ST SW STE 20",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268006",
            "telephone_number": "425-778-8116",
            "fax_number": "425-775-9626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7320 216TH ST SW STE 20",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268006",
            "telephone_number": "425-778-8116",
            "fax_number": "425-775-9526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLIANCE SURGEONS INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-27",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "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": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "601484763",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LABOR & INDUSTRIES",
            "identifier": "156966",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "700164800",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1042735",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Proliance Surgical Specialists of Edmonds",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Proliance Surgical Specialists of Edmonds",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Premier Therapy Associates, LLC
• Preserve Preventive Cardiology
• Erika Preston, LMHC
• Mariya Preston, L.M.P.
• Proliance Surgeons Inc P S (Proliance Edmonds Center for Outpatient Surgery)
• Proliance Surgeons Inc., P.S. (Proliance Northwest Pain Management Associates)
• Proliance Surgeons Inc., P.S. (Proliance Physical & Hand Therapy)
• Proliance Surgeons, Inc., P.S (Proliance Surgeons Ankle and Foot of Edmonds)
• Proliance Surgeons, Inc., P.S. (Proliance Surgeons Puget Sound ENT)
• Martin Proudfoot, M.D.

• Surgery Physician in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.