Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
Proliance The Children and Family Eye Doctors, Proliance Eastside ENT
Organization subpart
No
Provider details
NPI number
Authorized official
CORI M. PLEASANT (CREDENTIALING & ENROLLMENT MANAGER)
(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
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
207Y00000X
Otolaryngology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2001403
—
WA
01
—
222338
WA LABOR & INDUSTRIES
WA
Enumeration date
08/19/2007
Last updated
05/02/2025
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