Organization
PROLIANCE SURGEONS INC P S
Active
Other names
Proliance Skagit Northwest Orthopedic Surgery Center, Skagit Northwest Orthopedic ASC at LaVenture (FKA)
Organization subpart
No
Provider details
NPI number
Authorized official
CORI M. PLEASANT (DEL CRED & ENROLLMENT MANAGER)
(206) 838-2585
Entity
Organization
Contact information
Practice address
1401 S LAVENTURE RD, MOUNT VERNON, WA 98274-6033
(360) 424-7041
(360) 424-2418
Mailing address
1401 S LAVENTURE RD, MOUNT VERNON, WA 98274-6033
(360) 424-7041
(360) 424-2418
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
601484763
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1044177
—
WA
01
—
173752
WA LABOR & INDUSTRIES
WA
Enumeration date
05/25/2006
Last updated
09/12/2024
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