Proliance Surgeons, Inc., P.S.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

PROLIANCE SURGEONS, INC., P.S.

Practice address

7308 Bridgeport Way W Ste 201
Lakewood, WA 98499-8000

Phone

(253) 582-7257

Fax

(253) 582-1617

NPI assigned

Jun 10, 2005

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 10

Addresses

Other identifiers 2

Other names 1

• Proliance Puget Sound Orthopaedics Doing business as

Medicare fee-for-service enrollment

Enrolled in WA2 enrollments

Enrollment records 2

Locations

Practitioners 19

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

• Julian S Arroyo, MD

  • Orthopaedic Surgery Physician
  • Lakewood, WA
  • NPI 1114921707
  NPD
• Albert Max D'Heurle, M.D.

  • Orthopaedic Surgery Physician
  • Lakewood, WA
  • NPI 1255775219
  NPD
• Jason W Dahl, M.D.

  • Orthopaedic Hand Surgery Physician
  • Bellingham, WA
  • NPI 1144462367
  NPD
• Michael Kevin Gannon, M.D.

  • Orthopaedic Surgery Physician
  • Bellingham, WA
  • NPI 1790704856
  NPD
• Richard E Gray, MD

  • Orthopaedic Surgery of the Spine Physician
  • Lakewood, WA
  • NPI 1851352710
  NPD
• Kevin C Harris, M.D.

  • Otolaryngology Physician
  • Anacortes, WA
  • NPI 1164496808
  NPD
• Douglas M Hassan, MD

  • Orthopaedic Surgery Physician
  • Lakewood, WA
  • NPI 1407822919
  NPD
• Dawn Marie Hastreiter, MD, PHD

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1245339357
  NPD
• John Timothy Heffernan, M.D.

  • Orthopaedic Surgery Physician
  • Lakewood, WA
  • NPI 1972915627
  NPD
• Matthew V Jenkins, M.D.

  • Orthopaedic Surgery Physician
  • Lakewood, WA
  • NPI 1821263807
  NPD
• Suzanne E Jennings, AU.D.

  • Audiologist
  • Bellingham, WA
  • NPI 1740304336
  NPD
• Frederick Farzad Kash, MD

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1023070737
  NPD

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1891799490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7308 BRIDGEPORT WAY W STE 201",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984998000",
            "telephone_number": "253-582-7257",
            "fax_number": "253-582-1617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7308 BRIDGEPORT WAY W STE 201",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984998000",
            "telephone_number": "253-582-7257",
            "fax_number": "253-582-1617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1724 W Union Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984052099",
            "country_code": "US",
            "telephone_number": "253-830-5200",
            "fax_number": "253-752-1160",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1724 W Union Ave Ste B-100",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984052099",
            "country_code": "US",
            "telephone_number": "253-830-5215",
            "fax_number": "253-830-5219",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2727 Hollycroft St Ste 410",
            "address_purpose": "LOCATION",
            "city": "Gig Harbor",
            "state": "WA",
            "postal_code": "983351369",
            "country_code": "US",
            "telephone_number": "253-358-4002",
            "fax_number": "253-358-4015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROLIANCE SURGEONS, INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-10",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "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": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "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": "1046089",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA L&I",
            "identifier": "222246",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Proliance Puget Sound Orthopaedics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Proliance Puget Sound Orthopaedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Taulagooleafi D. Pritchard, MHCP
• Abigail Proctor
• Professional Registry of Nursing, Inc.
• Cheri Smith Profit, BA
• Proliance Surgeons, Inc., P.S.
• Sinoun Prom
• Promising Afh
• Tara Proper
• George A Prudden, PA-C
• Nicole Przychodzen

• Orthopaedic Surgery Physician in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Orthopaedic Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.