# PROLIANCE SURGEONS, INC., P.S.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Evergreen Surgical Clinic Ambulatory Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952340036
- **Authorized official:** MR. DAVID G. FITZGERALD (CEO)
- **Authorized official phone:** (206) 838-2599

## Contact information

- **Practice address:** 12333 NE 130TH LN, SUITE 420, KIRKLAND, WA 98034-7467
- **Practice address phone:** (425) 899-5500
- **Practice address fax:** (425) 899-5529
- **Mailing address:** 805 MADISON ST, SUITE 901, SEATTLE, WA 98104-1172
- **Mailing address phone:** (206) 264-8100
- **Mailing address fax:** (206) 264-8689

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 601484763 | WA | Yes |

## Other

- **Enumeration date:** 06/05/2006
- **Last updated:** 10/07/2011