{"npi":"1124500293","type":"NPI-2","status":"active","name":{"display":"Proliance Surgeons INC P S","other":[],"organization_name":"PROLIANCE SURGEONS INC P S","authorised_official":"Kenneth Overbey"},"specialty":{"primary_taxonomy":"207X00000X","primary_taxonomy_description":"Orthopaedic Surgery","slug":"orthopedic-surgery","schema_org_specialty":"PlasticSurgery","all":[{"code":"363AS0400X","description":"Surgical Physician Assistant","primary":false,"state":"WA","license":"601484763"},{"code":"208100000X","description":"Physical Medicine & Rehabilitation","primary":false,"state":"WA","license":"601484763"},{"code":"207X00000X","description":"Orthopaedic Surgery","primary":true,"state":"WA","license":"601484763"}]},"addresses":[{"purpose":"LOCATION","street_1":"510 8TH AVE NE STE 200","city":"ISSAQUAH","state":"WA","postal_code":"980295436","country_code":"US","phone":"4253923030","fax":"4253922564"},{"purpose":"MAILING","street_1":"510 8TH AVE NE STE 320","city":"ISSAQUAH","state":"WA","postal_code":"980295436","country_code":"US","phone":"4255070733","fax":"4252835551"}],"license":{"state":"WA","number":"601484763"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"2016746","state":"WA","issuer":null},{"type_code":"01","label":"Other","value":"122274","state":"WA","issuer":"LABOR & INDUSTRIES"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20190319002382","type_code":"30-20","type_desc":"DME SUPPLIER - PHYSICIAN - ORTHOPEDIC/ORTHOPEDIC SURGERY","state":"WA","pac_id":"8527972900"}]},"enumeration_date":"2018-09-05","last_updated":"2025-10-30","_meta":{"source":"NPPES","snapshot_date":"2025-10-30","doc_url":"https://findmynpi.com/api"}}