# PROLIANCE SURGEONS INC P S

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Proliance Edmonds Center for Outpatient Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295775369
- **Authorized official:** CORI M. PLEASANT (DEL CRED & ENROLLMENT MANAGER)
- **Authorized official phone:** (206) 838-2585

## Contact information

- **Practice address:** 7320 216TH ST SW STE 140, EDMONDS, WA 98026-8028
- **Practice address phone:** (206) 673-3750
- **Practice address fax:** (206) 673-3763
- **Mailing address:** 7320 216TH ST SW STE 140, EDMONDS, WA 98026-8028
- **Mailing address phone:** (425) 673-3750
- **Mailing address fax:** (425) 673-3763

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 601484763 | WA | Yes |

## Other

- **Enumeration date:** 06/07/2006
- **Last updated:** 10/04/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1043609 | — | WA |
| 01 | — | 173267 | WA LABOR & INDUSTRIES | WA |