Organization
PROLIANCE SURGEONS INC., P.S.
Active
Other names
Proliance ProOrtho Orthopedics, Sports, Joints and Spine
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
14841 179TH AVE SE STE 330, MONROE, WA 98272-1127
(360) 794-3300
(360) 794-6610
Mailing address
12911 120TH AVE NE STE G10, KIRKLAND, WA 98034-3048
(425) 823-4000
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
601484763
WA
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1015791
—
WA
01
—
51292
WA LABOR & INDUSTRIES
—
Enumeration date
06/05/2006
Last updated
08/22/2022
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