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General NPI Number Information
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NPI Number | 1083752042
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Entity Type | Organization
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Legal Business Name | PROLIANCE SURGEONS INC., P.S.
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 510 8TH AVE NE STE 340
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City | ISSAQUAH
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State | WA
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Zip | 98029-5449
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Country | US
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Telephone | 425-313-3051
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Fax | 425-313-3051
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Provider Business Mailing Address
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Address Line | 510 8TH AVE NE STE 320
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City | ISSAQUAH
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State | WA
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Zip | 98029-5436
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Country | US
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Telephone | 425-313-3055
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Fax | 425-313-3051
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | CORI M. PLEASANT
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Credential |
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Telephone | 206-838-2585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 601484763
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2251H1200X
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Taxonomy Name | Hand Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 601484763
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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