Proliance Surgeons, Inc., P.S.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

601 484 763 Issued in WA

Legal business name

PROLIANCE SURGEONS, INC., P.S.

Doing business as

Skagit Northwest Orthopedics ASC at Continental

Practice address

1500 Continental PL
Mount Vernon, WA 98273-4105

Phone

(360) 424-7041

Fax

(360) 424-2418

NPI assigned

Jul 19, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Laura Kleisle

Title

Chief Risk Officer

Phone

(206) 838-2590

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• SKAGIT NORTHWEST ORTHOPEDICS ASC AT CONTINENTAL Doing business as

Locations

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622073600000",
    "number": "1457350712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S LAVENTURE RD",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982746033",
            "telephone_number": "360-424-7041",
            "fax_number": "360-424-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CONTINENTAL PL",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982734105",
            "telephone_number": "360-424-7041",
            "fax_number": "360-424-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLIANCE SURGEONS, INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A",
        "authorized_official_last_name": "KLEISLE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "CHIEF RISK OFFICER",
        "authorized_official_telephone_number": "206-838-2590",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": "601 484 763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LABOR & INDUSTRIES",
            "identifier": "332935",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2033491",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SKAGIT NORTHWEST ORTHOPEDICS ASC AT CONTINENTAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SKAGIT NORTHWEST ORTHOPEDICS ASC AT CONTINENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pro Care Medical Group (Health Med Centers)
• Proliance Surgeons Inc P S (Proliance Skagit Northwest Orthopedic Surgery Center)
• Proliance Surgeons, Inc., P.S. (Proliance Surgeons Skagit Northwest Orthopedics)
• Proliance Surgeons, Inc., P.S. (Skagit Northwest Orthopedics MRI)
• Proliance Surgeons, Inc., P.S. (Cascade Ear Nose and Throat)
• Proliance Surgeons, Inc., P.S. (Proliance Surgeons Skagit Northwest Orthopedics/Physical Therapy)
• Proliance Surgeons, Inc., P.S. (Cascade Ear Nose and Throat Surgery Center)
• Christopher Prompuntagorn, MD
• Psychiatric Nurse Consulting & Therapy, LLC
• Public Hospital Dist No 1 Skagit (Skagit Regional Clinics)

• Ambulatory Surgical Clinic/Center in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Ambulatory Surgical Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.