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Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
Cascade Ear Nose and Throat Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID G FITZGERALD (CEO)
(206) 838-2599
Entity
Organization
Contact information
Practice address
111 S 13TH ST, MOUNT VERNON, WA 98274-4105
(360) 336-2178
(360) 588-7840
Mailing address
805 MADISON ST, SUITE 901, SEATTLE, WA 98104-1172
(206) 264-8100
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
601484763
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7009285
—
WA
Enumeration date
12/11/2006
Last updated
12/27/2013
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