Organization
PROLIANCE SURGEONS, INC., P.S
Active
Other names
Proliance Surgeons Ankle and Foot of Edmonds
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 320B, EDMONDS, WA 98026-8006
(425) 775-6996
(425) 670-8905
Mailing address
7320 216TH ST SW STE 320, EDMONDS, WA 98026-8006
(425) 673-3900
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
601484763
WA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0532700039
NSC DME
WA
05
—
1043983
—
WA
01
—
49391
WA LABOR & INDUSTRIES
WA
Enumeration date
02/16/2018
Last updated
08/18/2022
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