# PROLIANCE SURGEONS, INC., P.S.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CASCADE EAR NOSE AND THROAT
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215368717
- **Authorized official:** MR. DAVID G. FITZGERALD (CEO)
- **Authorized official phone:** (206) 838-2599

## Contact information

- **Practice address:** 111 S 13TH ST, MOUNT VERNON, WA 98274-4105
- **Practice address phone:** (360) 336-2178
- **Practice address fax:** (360) 336-2642
- **Mailing address:** 805 MADISON ST, SUITE 901, SEATTLE, WA 98104-1172
- **Mailing address phone:** (206) 264-8100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | 601484763 | WA | — |
| 207YS0123X | Facial Plastic Surgery Physician | 601484763 | WA | — |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | 601484763 | WA | — |
| 207YX0602X | Otolaryngic Allergy Physician | 601484763 | WA | — |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | 601484763 | WA | Yes |
| 208200000X | Plastic Surgery Physician | 601484763 | WA | — |
| 2082S0099X | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician | 601484763 | WA | — |
| 208600000X | Surgery Physician | 601484763 | WA | — |
| 2086S0122X | Plastic and Reconstructive Surgery Physician | 601484763 | WA | — |
| 2086X0206X | Surgical Oncology Physician | 601484763 | WA | — |
| 231H00000X | Audiologist | 601484763 | WA | — |
| 237600000X | Audiologist-Hearing Aid Fitter | 601484763 | WA | — |

## Other

- **Enumeration date:** 12/09/2013
- **Last updated:** 12/11/2013