Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
Proliance Surgeons Puget Sound ENT
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
21911 76TH AVE W STE 211, EDMONDS, WA 98026-7918
(425) 775-6651
(425) 670-6718
Mailing address
21911 76TH AVE W STE 211, EDMONDS, WA 98026-7918
(425) 775-6651
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
601484763
WA
207YX0901X
Otology & Neurotology Physician
—
—
231H00000X
Audiologist
601484763
WA
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1060556
—
WA
01
—
227718
LABOR & INDUSTRIES
WA
Enumeration date
11/23/2007
Last updated
11/01/2022
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