Proliance Surgeons Inc., P.S.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

601484763 Issued in WA

Legal business name

PROLIANCE SURGEONS INC., P.S.

Doing business as

Proliance Eastside Surgeons

Practice address

6505 226TH PL SE
Suite 101
Issaquah, WA 98027-8905

Phone

(425) 313-0775

Fax

(425) 313-4704

NPI assigned

Jun 5, 2006

Last updated

Jun 29, 2011By 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

Mr. David G. Fitzgerald

Title

Ceo

Phone

(206) 838-2599

Specialties & licenses 1

Addresses

Other names 1

• Proliance Eastside Surgeons Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 1

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.

• Jennifer Kay, OTR/L, CHT

  • Hand Occupational Therapist
  • Bellevue, WA
  • NPI 1740262948
  NPD

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309305600000",
    "number": "1639118649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100",
            "fax_number": "206-264-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6505 226TH PL SE",
            "address_2": "SUITE 101",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278905",
            "telephone_number": "425-313-0775",
            "fax_number": "425-313-4704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLIANCE SURGEONS INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-05",
        "last_updated": "2011-06-29",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "206-838-2599",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "601484763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Proliance Eastside Surgeons",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Robert Primrose, DDS
• Marina Prodanovic
• Proliance Surgeons Inc P S (Proliance Highlands Surgery Center)
• Proliance Surgeons Inc P S (Proliance Orthopaedics and Sports Medicine)
• Proliance Surgeons Inc., P.S. (Proliance Sports Therapy and Rehab of Issaquah)
• Proliance Surgeons, Inc., P.S. (Proliance Surgeons Bellevue ENT and Lake WA Facial Plastic Surgery)
• Proliance Surgeons, Inc., P.S. (Proliance Advanced Imaging Center)
• Proliance Surgeons, Inc., P.S. (Athena Women's Health)
• Proliance Surgeons, Inc., P.S. (Issaquah Surgery Center)
• Cheyanne Prominski, MSW

• Surgery Physician in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2011; 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.