Organization
PROLIANCE SURGEONS INC PS
Active
Other names
Proliance Hillside Medical Surgery Center
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
104 27TH AVE SE, PUYALLUP, WA 98374-1145
(253) 770-9000
(253) 770-9712
Mailing address
PO BOX 1205, PUYALLUP, WA 98371-0231
(253) 770-9000
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2068005
—
WA
01
—
352494
WA LABOR & INDUSTRIES
—
Enumeration date
06/25/2006
Last updated
12/06/2023
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