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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