Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
Evergreen Surgical Clinic Ambulatory Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID G. FITZGERALD (CEO)
(206) 838-2599
Entity
Organization
Contact information
Practice address
12333 NE 130TH LN, SUITE 420, KIRKLAND, WA 98034-7467
(425) 899-5500
(425) 899-5529
Mailing address
805 MADISON ST, SUITE 901, SEATTLE, WA 98104-1172
(206) 264-8100
(206) 264-8689
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
601484763
WA
Other
Enumeration date
06/05/2006
Last updated
10/07/2011
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