Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
CASCADE EAR NOSE AND THROAT
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) 336-2642
Mailing address
805 MADISON ST, SUITE 901, SEATTLE, WA 98104-1172
(206) 264-8100
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
601484763
WA
207YS0123X
Facial Plastic Surgery Physician
601484763
WA
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
601484763
WA
207YX0602X
Otolaryngic Allergy Physician
601484763
WA
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
601484763
WA
208200000X
Plastic Surgery Physician
601484763
WA
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
601484763
WA
208600000X
Surgery Physician
601484763
WA
2086S0122X
Plastic and Reconstructive Surgery Physician
601484763
WA
2086X0206X
Surgical Oncology Physician
601484763
WA
231H00000X
Audiologist
601484763
WA
237600000X
Audiologist-Hearing Aid Fitter
601484763
WA
Other
Enumeration date
12/09/2013
Last updated
12/11/2013
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