Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
Proliance Surgeons Minor and James
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
515 MINOR AVE STE 200, SEATTLE, WA 98104-2133
(206) 386-9668
Mailing address
515 MINOR AVE STE 200, SEATTLE, WA 98104-2133
(206) 386-3848
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
231H00000X
Audiologist
—
—
261Q00000X
Clinic/Center
601484763
WA
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2057738
—
WA
01
—
352253
WA LABOR & INDUSTRIES
WA
Enumeration date
02/16/2016
Last updated
12/30/2022
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