Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
Proliance Puget Sound Orthopaedics
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
7308 BRIDGEPORT WAY W STE 201, LAKEWOOD, WA 98499-8000
(253) 582-7257
(253) 582-1617
Mailing address
7308 BRIDGEPORT WAY W STE 201, LAKEWOOD, WA 98499-8000
(253) 582-7257
(253) 582-1617
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1046089
—
WA
01
—
222246
WA L&I
WA
Enumeration date
06/10/2005
Last updated
08/23/2022
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