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 Northwest Pain Management Associates
Proliance Physical & Hand Therapy
Proliance Surgeons Edmonds Orthopedic Center

Practice address

7320 216TH St SW Ste 320
Edmonds, WA 98026-8006

Phone

(425) 673-3900

Fax

(425) 673-3910

NPI assigned

Jun 14, 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 9

Addresses

Other identifiers 3

Other names 3

• Proliance Northwest Pain Management Associates Doing business as
• Proliance Physical & Hand Therapy Doing business as
• Proliance Surgeons Edmonds Orthopedic Center Doing business as

Medicare fee-for-service enrollment

Enrolled in WA2 enrollments

Enrollment records 2

Practitioners 13

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.

• Brian D. Cameron, M.D.

  • Orthopaedic Surgery Physician
  • Edmonds, WA
  • NPI 1194771998
  NPD
• Taylor Keiichi Chong, PA-C

  • Surgical Physician Assistant
  • Seattle, WA
  • NPI 1033887443
  NPD
• Aric A Christal, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Edmonds, WA
  • NPI 1770699159
  NPD
• Katherine E. R. Hazzard, PA-C

  • Surgical Physician Assistant
  • Seattle, WA
  • NPI 1346853801
  NPD
• Emma S. Helms, PA-C

  • Surgical Physician Assistant
  • Seattle, WA
  • NPI 1902463862
  NPD
• Hannah Sue Hults, PA-C

  • Surgical Physician Assistant
  • Seattle, WA
  • NPI 1619675329
  NPD
• Zachary Tyler Laidley, DPM

  • Podiatrist
  • Edmonds, WA
  • NPI 1639668833
  NPD
• Amy M Lentz, MPT

  • Physical Therapist
  • Edmonds, WA
  • NPI 1164546842
  NPD
• Meghan Kristine McDevitt, PA-C

  • Surgical Physician Assistant
  • Seattle, WA
  • NPI 1538712641
  NPD
• Gail D Petteruti, PAC

  • Surgical Physician Assistant
  • Seattle, WA
  • NPI 1295768356
  NPD
• Ravijeet Singh, DPT

  • Physical Therapist
  • Edmonds, WA
  • NPI 1992544738
  NPD
• Jayashree Srinivasan, MD

  • Neurological Surgery Physician
  • Seattle, WA
  • NPI 1407812134
  NPD

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718928000000",
    "number": "1386687747",
    "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",
            "fax_number": "206-673-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7320 216TH ST SW STE 320",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268006",
            "telephone_number": "425-673-3900",
            "fax_number": "425-673-3910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 153rd St SE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Mill Creek",
            "state": "WA",
            "postal_code": "980124051",
            "country_code": "US",
            "telephone_number": "425-673-3900",
            "fax_number": "425-673-3910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6808 220th St SW Ste 201",
            "address_purpose": "LOCATION",
            "city": "Mountlake Terrace",
            "state": "WA",
            "postal_code": "980432187",
            "country_code": "US",
            "telephone_number": "425-640-6976",
            "fax_number": "425-640-6977",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7320 216th St SW Ste 320",
            "address_purpose": "LOCATION",
            "city": "Edmonds",
            "state": "WA",
            "postal_code": "980268006",
            "country_code": "US",
            "telephone_number": "425-673-3916",
            "fax_number": "425-673-3926",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13020 Meridian Ave S",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982086468",
            "country_code": "US",
            "telephone_number": "425-673-3900",
            "fax_number": "425-673-3910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROLIANCE SURGEONS INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2024-06-21",
        "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": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "601484763",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "WA",
            "license": "601484763",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "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
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "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 L&I",
            "identifier": "49391",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043983",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "0532700040",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Proliance Northwest Pain Management Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Proliance Physical & Hand Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Proliance Surgeons Edmonds Orthopedic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 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 Surgical Specialists of Edmonds)
• 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.
• Psychiatry Evergreen PLLC

• Multi-Specialty Clinic/Center in Edmonds, WA
• Providers in Edmonds, 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 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.