Proliance Surgeons, Inc., P.S.

Primary specialty

Hand Occupational TherapistTaxonomy code 225XH1200X

Legal business name

PROLIANCE SURGEONS, INC., P.S.

Doing business as

Proliance Physical & Hand Therapy

Practice address

6808 220TH St SW Ste 200
Mountlake Terrace, WA 98043-2187

Phone

(425) 673-3916

Fax

(425) 673-3926

NPI assigned

Nov 19, 2021

Last updated

Aug 19, 2022By 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 2

Addresses

Other identifiers 1

Other names 1

• Proliance Physical & Hand Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

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

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660867200000",
    "number": "1235896630",
    "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": "425-673-3916",
            "fax_number": "425-673-3926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6808 220TH ST SW STE 200",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432187",
            "telephone_number": "425-673-3916",
            "fax_number": "425-673-3926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLIANCE SURGEONS, INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-19",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "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": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "0532700040",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Proliance Physical & Hand Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Hand Occupational Therapist in Mountlake Terrace, WA
• Providers in Mountlake Terrace, WA by specialty
• Hand Occupational Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.