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Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
Proliance Ear Nose Throat and Allergy Associates
Organization subpart
No
Provider details
NPI number
Authorized official
CORI M. PLEASANT (MGR PROVIDER RELATIONS/ENROLLMENT)
(206) 838-2585
Entity
Organization
Contact information
Practice address
104 27TH AVE SE, PUYALLUP, WA 98374-1145
(253) 770-9712
(253) 770-9712
Mailing address
PO BOX 1205, PUYALLUP, WA 98371-0231
(253) 770-9000
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
601484763
WA
207Y00000X
Otolaryngology Physician
Primary
601484763
WA
231H00000X
Audiologist
601484763
WA
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2049207
—
WA
01
—
345481
LABOR & INDUSTRIES
WA
Enumeration date
08/31/2015
Last updated
05/31/2024
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