Proliance Surgeons Inc PS

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

PROLIANCE SURGEONS INC PS

Doing business as

Evergreen Surgical Clinic

Practice address

14841 179TH Ave SE
Suite 220
Monroe, WA 98272-1127

Phone

(360) 863-8141

Fax

(360) 805-9781

NPI assigned

Feb 14, 2007

Last updated

Aug 22, 2020By 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

Mr. David G. Fitzgerald

Title

Ceo

Phone

(206) 838-2590

Specialties & licenses 1

Addresses

Other names 1

• Evergreen Surgical Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

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.

• Kenneth C Lin, M.D.

  • Orthopaedic Surgery Physician
  • Monroe, WA
  • NPI 1033263256
  NPD

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144362047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 OLIVE WAY",
            "address_2": "SUITE 1505",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011878",
            "telephone_number": "206-838-2590",
            "fax_number": "206-264-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14841 179TH AVE SE",
            "address_2": "SUITE 220",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721127",
            "telephone_number": "360-863-8141",
            "fax_number": "360-805-9781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLIANCE SURGEONS INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "206-838-2590",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Surgical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniel Piersee, PHARMD
• Alfonso F Pineyro, D.D.S.
• William Pittman Jr., MASSAGE PRACTITIONER
• Ranjana Neelam Prasad
• Robert Llewellyn Pratt, D.D.S.
• Proliance Surgeons Inc., P.S. (Proliance ProOrtho Orthopedics, Sports, Joints and Spine)
• Providence Health & Services - Washington (PMG NW WA Monroe Family Medicine)
• Providence Health & Services - Washington (PMG NW WA Monroe Internal Medicine)
• Providence Health & Services - Washington (PMG NW WA Monroe Walk In Clinic)
• Providence Health & Services-Wa (PMG NW WA Midwifery Monrole)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.