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Organization
PROLIANCE SURGEONS INC PS
Active
Organization
PROLIANCE SURGEONS INC PS
Active
Other names
Proliance Hillside Medical Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
CORI M. PLEASANT (DEL CRED & ENROLLMENT MANAGER)
(206) 838-2585
Entity
Organization
Contact information
Practice address
104 27TH AVE SE, PUYALLUP, WA 98374-1145
(253) 770-9000
(253) 770-9712
Mailing address
PO BOX 1205, PUYALLUP, WA 98371-0231
(253) 770-9000
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2068005
—
WA
01
—
352494
WA LABOR & INDUSTRIES
—
Enumeration date
06/25/2006
Last updated
12/06/2023
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