PROLIANCE RETINA – NPI #1841568946
Ophthalmology

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

PROLIANCE RETINA is an ophthalmologist located in BELLEVUE, WA. NPPES has assigned the NPI number 1841568946 to PROLIANCE RETINA on December 05, 2011. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “PROLIANCE RETINA” is a dba name, the actual legal business name for this organization is PROLIANCE SURGEONS, INC., P.S.. According to the NPI Registry, there are 8 additional location(s) assigned to this provider which are listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207W00000X from the Health Care Provider Taxonomy code set, which is classified as Ophthalmology.

The NPI profile was previously updated about 5 years ago on May 28, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PROLIANCE RETINA below.

NPI Profile for
PROLIANCE SURGEONS, INC., P.S.

NPI Number
1841568946
Enumeration Date

(more than 14 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PROLIANCE SURGEONS, INC., P.S.
Doing Business As (dba): PROLIANCE RETINA
Primary location
1750 112TH AVE NE STE D050
BELLEVUE, WA 98004
Phone: (206) 215-3850 Fax: (206) 215-3870
8 Other location(s):
3105 Old Fairhaven Pkwy Ste 103
Bellingham, WA 98225-8212
Phone: (206) 215-3850
Fax: (206) 215-3870
215 E George Hopper Rd
Burlington, WA 98233-3105
Phone: (206) 215-3850
Fax: (206) 215-3870
109 NE Birch St
Coupeville, WA 98239-3133
Phone: (206) 215-3850
Fax: (206) 215-3870
2205 W Dolarway Rd Ste 2
Ellensburg, WA 98926-8241
Phone: (206) 215-3850
Fax: (206) 215-3870
321 Ramsay Way Ste 107
Kent, WA 98032-4544
Phone: (206) 215-3850
Fax: (206) 215-3870
6100 219th St SW Ste 280
Mountlake Terrace, WA 98043-2222
Phone: (206) 215-3850
Fax: (206) 215-3870
1229 Madison St Ste 620
Seattle, WA 98104-3304
Phone: (206) 215-3850
Fax: (206) 215-3870
1229 Madison St Ste 680
Seattle, WA 98104-3541
Phone: (206) 215-3850
Fax: (206) 215-3870
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
LAURA KLEISLE
CHIEF RISK OFFICER
Phone: (206) 838-2590
Updated
Certification Date
May 28, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for PROLIANCE RETINA

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERLABOR & INDUSTRIESWA288391
MEDICAIDWA2016220
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207W00000X
- Ophthalmology (Primary)
WA 601484763
261QM1300X
- Clinic/Center / Multi-Specialty
WA 601484763
207WX0107X
- Ophthalmology / Retina Specialist
WA 601484763

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.