Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
PROLIANCE MRI NORTH PUGET SOUND
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
6808 220TH ST SW STE 105, MOUNTLAKE TERRACE, WA 98043-2187
(425) 967-6490
(425) 967-6495
Mailing address
7320 216TH ST SW STE 320, EDMONDS, WA 98026-8006
(425) 673-3900
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
601484763
WA
261QR0200X
Radiology Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2155286
—
WA
Enumeration date
08/17/2017
Last updated
08/22/2022
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