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General NPI Number Information
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NPI Number | 1275345456
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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 | 01/23/2025
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 10821 19TH AVE SE STE 201
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City | EVERETT
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State | WA
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Zip | 98208-5103
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Country | US
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Telephone | 425-337-7000
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Fax | 425-338-2408
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Provider Business Mailing Address
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Address Line | 1100 PACIFIC AVE STE 300
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City | EVERETT
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State | WA
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Zip | 98201-4261
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DEL CRED & ENROLLMENT MANAGER
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Name | MRS. 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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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