Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
Proliance The Children and Family Eye Doctors
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
17130 AVONDALE WAY NE STE 111, REDMOND, WA 98052-4455
(425) 885-6600
(425) 885-6580
Mailing address
17130 AVONDALE WAY NE STE 111, REDMOND, WA 98052-4455
(425) 885-6600
(425) 885-6580
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
601484763
WA
207W00000X
Ophthalmology Physician
Primary
601484763
WA
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2001403
—
WA
01
—
222338
WA STATE L & I
WA
Enumeration date
08/05/2016
Last updated
08/22/2022
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