Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Provascular Surgery Associates PLLC

Organization Vascular Surgery Physician · NPI 1174851810

Provascular Surgery Associates PLLC is a Vascular Surgery Physician in Renton, Washington. Licensed in Washington. Registered with an NPI since 2009.

Licensed in
WA
In the registry since
2009
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4300 Talbot Rd S Ste 101
Renton, WA 98055-6328
Phone: (425) 227-4341
Fax: (425) 793-6045
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Vascular Surgery Physician (primary) Taxonomy 2086S0129X · Licence MD60106870 (WA)

Record details

NPI number1174851810
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dennis Su — Physician/Owner · (425) 227-4341
NPI enumeratedNovember 18, 2009
Last updated in NPPESDecember 12, 2014
Mailing address4300 Talbot Rd S, Ste 101, Renton, WA 98055-6238

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