Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
Proliance Ear Nose Throat and Allergy 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
104 27TH AVE SE, PUYALLUP, WA 98374-1145
(253) 770-9712
(253) 770-9712
Mailing address
PO BOX 1205, PUYALLUP, WA 98371-0231
(253) 770-9000
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
601484763
WA
207Y00000X
Otolaryngology Physician
Primary
601484763
WA
231H00000X
Audiologist
601484763
WA
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2049207
—
WA
01
—
345481
LABOR & INDUSTRIES
WA
Enumeration date
08/31/2015
Last updated
05/31/2024
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