Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
Proliance Rehabilitation, Sports and Spine Center
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
3216 NORTON AVE STE 101, EVERETT, WA 98201-4290
(425) 252-4700
(425) 252-4788
Mailing address
7320 216TH ST SW STE 320, EDMONDS, WA 98026-8006
(425) 673-3900
(425) 252-4788
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
601484763
WA
261Q00000X
Clinic/Center
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043983
—
WA
01
—
49391
WA LABOR & INDUSTRIES
WA
Enumeration date
11/07/2016
Last updated
08/22/2022
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