Proliance Surgeons, Inc., P.S.

Primary specialty

Hand Occupational TherapistTaxonomy code 225XH1200X

License

601484763 Issued in WA

Legal business name

PROLIANCE SURGEONS, INC., P.S.

Practice address

15808 Mill Creek Blvd Ste 120
Mill Creek, WA 98012-1500

Phone

(425) 225-6867

Fax

(425) 332-2494

NPI assigned

Mar 16, 2015

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 2

Other names 1

• Proliance Physical & Hand Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 9

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

• David A. Applbaum, PA-C

  • Surgical Physician Assistant
  • Edmonds, WA
  • NPI 1568845253
  NPD
• Benjamin Chia, M.D.

  • Orthopaedic Hand Surgery Physician
  • Edmonds, WA
  • NPI 1639465024
  NPD
• Nicholas S. Dichiara, PA-C

  • Surgical Physician Assistant
  • Edmonds, WA
  • NPI 1649883166
  NPD
• Serena Lu, OTR/L, CHT

  • Hand Occupational Therapist
  • Edmonds, WA
  • NPI 1245116300
  NPD
• David Beck Nelles, MD

  • Orthopaedic Surgery Physician
  • Edmonds, WA
  • NPI 1760710610
  NPD
• Erin T Rajca, DPT

  • Physical Therapist
  • Edmonds, WA
  • NPI 1407026966
  NPD
• Sandra J. Weyrauch, PT

  • Physical Therapist
  • Mill Creek, WA
  • NPI 1841253317
  NPD
• Craig Frank Whitfield, PA-C

  • Medical Physician Assistant
  • Mountlake Terrace, WA
  • NPI 1689714693
  NPD
• Jay A Kaiser, M.D.

  • Diagnostic Radiology Physician
  • Greenbrae, CA
  • NPI 1275519001
  NPD

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

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1467845321",
    "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": "15808 MILL CREEK BLVD STE 120",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121500",
            "telephone_number": "425-225-6867",
            "fax_number": "425-332-2494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "190 W Dayton St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Edmonds",
            "state": "WA",
            "postal_code": "980207221",
            "country_code": "US",
            "telephone_number": "425-582-8118",
            "fax_number": "425-582-7420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROLIANCE SURGEONS, INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-16",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "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": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "601484763",
            "primary": false
        },
        {
            "code": "2251H1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": "WA",
            "license": "601484763",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LABOR & INDUSTRIES",
            "identifier": "338245",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2155550",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Proliance Physical & Hand Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marisel Pretorius
• Jennifer Anna Phan Prewitt, DPT
• Matthew G Price, MD
• Primelife PLLC
• Proliance Surgeons, Inc., P.S.
• Providence Health & Services- Washington
• Kayla Pruitt, D.C.
• Ann Marie Pryich, M.S.W.
• Puget Sound Gastroenterology, PLLC
• Breeanna R Pumper, PT

• Hand Occupational Therapist in Mill Creek, WA
• Providers in Mill Creek, 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 May 8, 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.