| NPI | 1073540894 |
|---|---|
| Doing Business As | PROLIANCE SURGICAL SPECIALISTS OF EDMONDS |
| Entity Type | Organization |
| Authorized Contact | CORI M. PLEASANT Mgr Provider Relations & Enrollment 206-838-2585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck |
| 208600000X Surgery (Licence: WA 601484763) | |
| 208C00000X Colon & Rectal Surgery | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2023-09-27 |