Proliance Surgeons, Inc., P.S.

Primary specialty

Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X

License

601484763 Issued in WA

Legal business name

PROLIANCE SURGEONS, INC., P.S.

Practice address

6808 220TH St SW Ste 105
Mountlake Terrace, WA 98043-2187

Phone

(425) 967-6490

Fax

(425) 967-6495

NPI assigned

Aug 17, 2017

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 5

Addresses

Other identifiers 1

Other names 1

• PROLIANCE MRI NORTH PUGET SOUND Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sean M Amann, MD

  • Orthopaedic Surgery Physician
  • Edmonds, WA
  • NPI 1467462861
  NPD
• Hsiao-Siu Chang, MS, OTR/L, CHT

  • Occupational Therapist
  • Lynnwood, WA
  • NPI 1487616975
  NPD
• James P Crutcher Jr., M.D.

  • Orthopaedic Surgery Physician
  • Seattle, WA
  • NPI 1881663292
  NPD
• Karlie Michelle Harrell, PT, DPT

  • Physical Therapist
  • Edmonds, WA
  • NPI 1578939294
  NPD
• Eric G Powell, DPM

  • Foot & Ankle Surgery Podiatrist
  • Mount Vernon, WA
  • NPI 1053623983
  NPD
• Darren J Wardle, DPM

  • Foot & Ankle Surgery Podiatrist
  • Edmonds, WA
  • NPI 1760566426
  NPD
• Justin Lann Esterberg, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Gilbert, AZ
  • NPI 1558494427
  NPD
• Lawrence J Fowler, M.D.

  • Anesthesiology Physician
  • Lansdowne, VA
  • NPI 1598734873
  NPD

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661126400000",
    "number": "1184140477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7320 216TH ST SW STE 320",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268006",
            "telephone_number": "425-673-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6808 220TH ST SW STE 105",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432187",
            "telephone_number": "425-967-6490",
            "fax_number": "425-967-6495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLIANCE SURGEONS, INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-17",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "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": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471M1202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Magnetic Resonance Imaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "WA",
            "license": "601484763",
            "primary": true
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2155286",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROLIANCE MRI NORTH PUGET SOUND",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Arynn Prescott, LMFTA
• Annika Previs
• Prism Behavioral Consulting LLC
• Proliance Surgeons Inc P S
• Proliance Surgeons, Inc., P.S
• Proliance Surgeons, Inc., P.S.
• Puget Sound Kidney Centers
• Lauren Qualls, LMHC
• Kristina Marie Malijan Quick, DPT
• Teresa Quinlan, COTA

• Magnetic Resonance Imaging (MRI) Clinic/Center in Mountlake Terrace, WA
• Providers in Mountlake Terrace, WA by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.