Organization
PROLIANCE SURGEONS INC., P.S.
Active
Organization
PROLIANCE SURGEONS INC., P.S.
Active
Other names
Proliance Surgeons Edmonds Orthopedic Center, Proliance Physical & Hand Therapy, Proliance Northwest Pain Management Associates
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
7320 216TH ST SW STE 320, EDMONDS, WA 98026-8006
(425) 673-3900
(425) 673-3910
Mailing address
7320 216TH ST SW STE 320, EDMONDS, WA 98026-8006
(425) 673-3900
(206) 673-3910
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207X00000X
Orthopaedic Surgery Physician
601484763
WA
208VP0014X
Interventional Pain Medicine Physician
601484763
WA
2251X0800X
Orthopedic Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0532700040
DME
WA
05
—
1043983
—
WA
01
—
49391
WA L&I
WA
Enumeration date
06/14/2006
Last updated
06/21/2024
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