Organization
PROLIANCE SURGEONS, INC., P.S.
Active
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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