Proliance Surgeons, Inc., P.S.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

PROLIANCE SURGEONS, INC., P.S.

Doing business as

Proliance Eastside ENT

Practice address

8301 161St Ave NE Ste 200
Redmond, WA 98052-3858

Phone

(425) 869-4855

Fax

(425) 869-4858

NPI assigned

Aug 21, 2007

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 4

Addresses

Other identifiers 2

Other names 1

• Proliance Eastside ENT Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

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

• Steven Michael Dawson, M.D.

  • Otolaryngology Physician
  • Kirkland, WA
  • NPI 1538169768
  NPD

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622160000000",
    "number": "1578756706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 116TH AVE NE STE 102",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043058",
            "telephone_number": "425-451-3710",
            "fax_number": "425-451-2636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 161ST AVE NE STE 200",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523858",
            "telephone_number": "425-869-4855",
            "fax_number": "425-869-4858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLIANCE SURGEONS, INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-21",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "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": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "601484763",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2001403",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LABOR & INDUSTRIES",
            "identifier": "222338",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Proliance Eastside ENT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Proliance Eastside ENT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Lauren Prince, APRN
• Mary Lisa Prince, MSPT
• Proliance Surgeons Inc P S
• Proliance Surgeons, Inc., P.S.
• Proliance Surgeons, Inc., P.S.
• David M Proscia, LMHCA
• John Joseph Prospal, MA, LMHC, CMHS
• Julia Prud'Homme, LMFT
• Amber May Pryor
• Paige Elizabeth Pryson

• Otolaryngology Physician in Redmond, WA
• Providers in Redmond, WA by specialty
• Otolaryngology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.