PROLIANCE SURGEONS INC. P.S. NPI 1184106262

NPI Information

NPI: 1184106262
Provider Name: PROLIANCE SURGEONS, INC., P.S.

Doing Business As: PROLIANCE ORTHOPAEDICS AND SPORTS MEDICINE

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
18100 NE UNION HILL RD STE 330
REDMOND, WA
ZIP 98052
Phone: (425) 392-3030
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PROLIANCE SURGEONS, INC., P.S. is a multi-specialty clinic center in Redmond, WA. PROLIANCE SURGEONS, INC., P.S. NPI is 1184106262. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Proliance Orthopaedics And Sports Medicine.

The provider's business location address is:

18100 NE UNION HILL RD STE 330
REDMOND, WA
ZIP 98052-330
Phone: (425) 392-3030
Fax: (425) 497-9084

The provider's authorized official is Kenneth G. Overbey .
The authorized official title is Coo and has the following contact phone number (206) 838-2583.

The enumeration date for this NPI number is 9/5/2018 and was last updated on 2/20/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207X00000X	Orthopaedic Surgery		601484763	WASHINGTON	No
2	208100000X	Physical Medicine & Rehabilitation		601484763	WASHINGTON	No
3	363AS0400X	Physician Assistant	Surgical	601484763	WASHINGTON	No
4	261QM1300X	Clinic/Center	Multi-Specialty	601484763	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2016746	MEDICAID	WASHINGTON
2	122274	OTHER	WASHINGTON	LABOR AND INDUSTRIES

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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