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NPI 1922902188

NPI 1922902188 : PROLIANCE SURGEONS INC P S : COVINGTON, WA

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General NPI Number Information
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    NPI Number           |    1922902188
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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     |    10/02/2026
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    Last Update Date     |    10/02/2026
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Provider Practice Location Address
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    Address Line         |    27005 168TH PL SE STE 200 
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    City                 |    COVINGTON
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    State                |    WA
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    Zip                  |    98042-4902
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    Country              |    US
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    Telephone            |    425-291-1470
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    Fax                  |    425-291-1491
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Provider Business Mailing Address
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    Address Line         |    4011 TALBOT RD S STE 300 
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    City                 |    RENTON
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    State                |    WA
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    Zip                  |    98055-5791
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    Country              |    US
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    Telephone            |    425-656-5060
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    Fax                  |    425-656-5047
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Authorized Official
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    Title or Position    |    DEL CRED & ENROLLMENT 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        |    332B00000X
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    Taxonomy Name        |    Durable Medical Equipment & Medical Supplies
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    License Number       |    
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    License Number State |    NULL
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Taxonomy #2
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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 |    NULL
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Taxonomy #3
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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 |    NULL
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