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Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Parent organization
PROLIANCE SURGEONS, INC. P.S.
Other names
Lakewood Surgery Center (FKA), Proliance Puget Sound Surgery Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROLIANCE SURGEONS, INC. P.S.
Authorized official
CORI M. PLEASANT (DEL CRED & ENROLLMENT MANAGER)
(206) 838-2585
Entity
Organization
Contact information
Practice address
7308 BRIDGEPORT WAY W STE 102, LAKEWOOD, WA 98499-8000
(253) 584-5252
(253) 582-1617
Mailing address
7308 BRIDGEPORT WAY W STE 102, LAKEWOOD, WA 98499-8000
(253) 584-5252
(253) 582-1617
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
601484763
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043206
—
WA
01
—
223794
WA LABOR & INDUSTRIES
WA
01
—
612815300
OWCP
—
Enumeration date
08/11/2005
Last updated
12/06/2023
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