Organization
PROLIANCE SURGEONS INC., P.S.
Active
Other names
Proliance Orthopaedics and Sports Medicine
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
3101 NORTHUP WAY STE 201, BELLEVUE, WA 98004-1449
(425) 455-3600
(425) 455-3920
Mailing address
510 8TH AVE NE STE 320, ISSAQUAH, WA 98029-5436
(425) 507-0733
(425) 283-5551
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0122274
L & I
WA
01
—
0532700042
DME
WA
01
—
192649200
OWCP
WA
05
—
2016746
—
WA
Enumeration date
06/28/2006
Last updated
09/27/2023
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