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Organization

PROLIANCE SURGEONS, INC., P.S.

Active
Other names
Northwest Orthopaedic and Sports Medicine
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID G. FITZGERALD (CEO)
(206) 838-2599
Entity
Organization

Contact information

Practice address
875 SWIFT BLVD, RICHLAND, WA 99352-3592
(509) 946-1654
(509) 943-5652
Mailing address
805 MADISON ST, SUITE 901, SEATTLE, WA 98104-1172
(206) 264-8100
(206) 264-8689

Taxonomy

Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
207X00000X
Orthopaedic Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0287402
L & I
WA
Enumeration date
11/10/2011
Last updated
12/09/2011
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