Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
Proliance Surgeons Three Rivers Ear, Nose and Throat
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
7105 W HOOD PL STE A103, KENNEWICK, WA 99336-6714
(509) 735-5551
(509) 735-5552
Mailing address
7105 W HOOD PL STE A103, KENNEWICK, WA 99336-6714
(509) 735-5551
(509) 735-5552
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
601484763
WA
231H00000X
Audiologist
601484763
WA
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2024012
—
WA
01
—
300290
WA LABOR & INDUSTRIES
WA
Enumeration date
10/05/2012
Last updated
08/22/2022
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