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Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
Proliance Surgeons Puget Sound ENT
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
21911 76TH AVE W STE 211, EDMONDS, WA 98026-7918
(425) 775-6651
(425) 670-6718
Mailing address
21911 76TH AVE W STE 211, EDMONDS, WA 98026-7918
(425) 775-6651
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
601484763
WA
207YX0901X
Otology & Neurotology Physician
—
—
231H00000X
Audiologist
601484763
WA
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1060556
—
WA
01
—
227718
LABOR & INDUSTRIES
WA
Enumeration date
11/23/2007
Last updated
11/01/2022
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