Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
Proliance Surgeons Everett Bone and Joint MRI, Proliance Surgeons Everett Bone and Joint
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
1100 PACIFIC AVE STE 300, EVERETT, WA 98201-4261
(425) 339-2433
(425) 339-8273
Mailing address
1100 PACIFIC AVE STE 300, EVERETT, WA 98201-4261
(425) 339-2433
(425) 339-8273
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123308
WA LABOR & INDUSTRIES
WA
05
—
2012655
—
WA
Enumeration date
06/05/2006
Last updated
08/22/2022
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