# PROLIANCE SURGEONS, INC., P.S

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Proliance Surgeons Ankle and Foot of Edmonds
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659871622
- **Authorized official:** CORI M. PLEASANT (MGR PROVIDER RELATIONS/ENROLLMENT)
- **Authorized official phone:** (206) 838-2585

## Contact information

- **Practice address:** 7320 216TH ST SW STE 320B, EDMONDS, WA 98026-8006
- **Practice address phone:** (425) 775-6996
- **Practice address fax:** (425) 670-8905
- **Mailing address:** 7320 216TH ST SW STE 320, EDMONDS, WA 98026-8006
- **Mailing address phone:** (425) 673-3900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 601484763 | WA | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 02/16/2018
- **Last updated:** 08/18/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0532700039 | NSC DME | WA |
| 05 | — | 1043983 | — | WA |
| 01 | — | 49391 | WA LABOR & INDUSTRIES | WA |