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General NPI Number Information
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NPI Number | 1184106262
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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 | 09/05/2018
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 18100 NE UNION HILL RD STE 330
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City | REDMOND
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State | WA
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Zip | 98052-3330
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Country | US
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Telephone | 425-392-3030
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Fax | 425-497-9084
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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 | 206-507-0733
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Fax | 206-283-5551
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Authorized Official
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Title or Position | DEL CRED & ENROLLMENT MANAGER
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Name | MRS. CORI 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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 601484763
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 601484763
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License Number State | WA
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