| NPI | 1255736971 |
|---|---|
| Doing Business As | PROLIANCE PUYALLUP SURGEONS |
| Entity Type | Organization |
| Authorized Contact | CORI M. PLEASANT Mgr Provider Relations/Enrollment 206-838-2585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA 601484763) |
| Additional Taxonomies | 208800000X Urology (Licence: WA 601484763) |
| 208C00000X Colon & Rectal Surgery (Licence: WA 601484763) | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 2086X0206X Surgery Surgical Oncology (Licence: WA 601484763) | |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2022-08-19 |