Proliance Surgeons, Inc., P.S.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

PROLIANCE SURGEONS, INC., P.S.

Doing business as

Proliance ProSports Imaging NW MRI
Proliance Rainier Orthopedic Institute

Practice address

3801 5TH St SE Ste 110
Puyallup, WA 98374-2106

Phone

(253) 845-9585

Fax

(253) 435-4785

NPI assigned

Oct 11, 2005

Last updated

Aug 22, 2022By 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

Cori M. Pleasant

Title

MGR Provider Relations/Enrollment

Phone

(206) 838-2585

Specialties & licenses 6

Addresses

Other identifiers 3

Other names 2

• Proliance ProSports Imaging NW MRI Doing business as
• Proliance Rainier Orthopedic Institute Doing business as

Medicare fee-for-service enrollment

Enrolled in WA2 enrollments

Enrollment records 2

Locations

Practitioners 17

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.

• Ryan Wayne Bahr, PA-C

  • Surgical Physician Assistant
  • Seattle, WA
  • NPI 1700402088
  NPD
• Katelyn Rae Genova, PA-C

  • Surgical Physician Assistant
  • Puyallup, WA
  • NPI 1083206973
  NPD
• Frederic L Johnstone, MD

  • Orthopaedic Surgery Physician
  • Puyallup, WA
  • NPI 1447286521
  NPD
• Cholwoo Anthony Kim, M.D.

  • Surgery Physician
  • Puyallup, WA
  • NPI 1134293277
  NPD
• Robin Yune Lee, MD

  • Urology Physician
  • Seattle, WA
  • NPI 1801098405
  NPD
• Robert E. Marsh, M.D.

  • Surgery Physician
  • Puyallup, WA
  • NPI 1710906243
  NPD
• Eric Geoffrey Puttler, M.D.

  • Orthopaedic Trauma Physician
  • Puyallup, WA
  • NPI 1538138268
  NPD
• John T Steedman Jr., MD

  • Orthopaedic Surgery Physician
  • Puyallup, WA
  • NPI 1013951805
  NPD
• Brandon Alan Swisher, PA-C

  • Surgical Physician Assistant
  • Bonney Lake, WA
  • NPI 1013949452
  NPD
• Benjamin Wibonele, MD

  • Otolaryngology Physician
  • Puyallup, WA
  • NPI 1285255448
  NPD
• Jeffrey C. Zhou, PA-C

  • Surgical Physician Assistant
  • Puyallup, WA
  • NPI 1598523649
  NPD
• Audra Lynn Wilson, PAC

  • Physician Assistant
  • Boise, ID
  • NPI 1336734789
  NPD

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661126400000",
    "number": "1952399123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 5TH ST SE STE 110",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983742106",
            "telephone_number": "253-845-9585",
            "fax_number": "253-848-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 5TH ST SE STE 110",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983742106",
            "telephone_number": "253-845-9585",
            "fax_number": "253-435-4785"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20920 SR 410 E",
            "address_purpose": "LOCATION",
            "city": "Bonney Lake",
            "state": "WA",
            "postal_code": "983916302",
            "country_code": "US",
            "telephone_number": "253-845-9585",
            "fax_number": "253-848-1126",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3801 5th St SE Ste 120",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983742106",
            "country_code": "US",
            "telephone_number": "253-864-4106",
            "fax_number": "253-864-4143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROLIANCE SURGEONS, INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "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": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2471M1202X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Magnetic Resonance Imaging",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1046356",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA L&I",
            "identifier": "218643",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "0532700022",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Proliance ProSports Imaging NW MRI",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Proliance Rainier Orthopedic Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Proliance Surgeons Inc PS (Proliance Hillside Medical Surgery Center)
• Proliance Surgeons, Inc., P.S. (Puyallup Ambulatory Surgery Center)
• Proliance Surgeons, Inc., P.S. (Proliance Puyallup Surgeons)
• Proliance Surgeons, Inc., P.S. (Proliance Ear Nose Throat and Allergy Associates)
• Proliance Surgeons, Inc., P.S. (ProSports Imaging NW MRI)
• Prompt Care Direct LLC
• Gregory Bryant Proulx, ARNP
• Amy Elizabeth Pruitt, LMFT
• Christoph Michael Prummer, M.D.
• Somchin Nicholas Puangsuvan, M.D.

• Orthopaedic Surgery Physician in Puyallup, WA
• Providers in Puyallup, 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 22, 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.