Healthcare Provider Details

I. General information

NPI: 1932023249
Provider Name (Legal Business Name): PROLIANCE SURGEONS INC P S
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20920 SR 410 E
BONNEY LAKE WA
98391-6302
US

IV. Provider business mailing address

3801 5TH ST SE STE 110
PUYALLUP WA
98374-2106
US

V. Phone/Fax

Practice location:
  • Phone: 253-845-9585
  • Fax: 253-848-1126
Mailing address:
  • Phone: 425-845-9585
  • Fax: 253-848-1126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: CORI M. PLEASANT
Title or Position: DEL CRED & ENROLLMENT MANAGER
Credential:
Phone: 206-838-2585