Organization
PROLIANCE SURGEONS INC P S
Active
Organization
PROLIANCE SURGEONS INC P S
Active
Other names
PROLIANCE ORTHOPAEDICS AND SPORTS MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH G. OVERBEY (COO)
(206) 838-2583
Entity
Organization
Contact information
Practice address
510 8TH AVE NE STE 200, ISSAQUAH, WA 98029-5436
(425) 392-3030
(425) 392-2564
Mailing address
510 8TH AVE NE STE 320, ISSAQUAH, WA 98029-5436
(425) 507-0733
(425) 283-5551
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
601484763
WA
208100000X
Physical Medicine & Rehabilitation Physician
601484763
WA
363AS0400X
Surgical Physician Assistant
601484763
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122274
LABOR & INDUSTRIES
WA
05
—
2016746
—
WA
Enumeration date
09/05/2018
Last updated
10/30/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up