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Organization

PROLIANCE SURGEONS, INC., P.S.

Active
Other names
Proliance Surgeons Bellevue Ear Nose and Throat and Sound Hearing, Proliance Surgeons Bellevue ENT and Lake WA Facial Plastic Surgery
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
510 8TH AVE NE STE 310, ISSAQUAH, WA 98029-5436
(425) 454-3938
(425) 392-3561
Mailing address
510 8TH AVE NE STE 310, ISSAQUAH, WA 98029-5436
(425) 454-3938
(425) 392-3561

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
601484763
WA
207Y00000X
Otolaryngology Physician
Primary
207YS0123X
Facial Plastic Surgery Physician
231H00000X
Audiologist
261QM1300X
Multi-Specialty Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1060221
WA
01
229378
WA LABOR & INDUSTRIES
WA
Enumeration date
02/22/2008
Last updated
08/22/2022
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