| NPI | 1528304292 |
|---|---|
| Doing Business As | PROLIANCE EASTSIDE ENT |
| Entity Type | Organization |
| Authorized Contact | LAURA KLEISLE Chief Risk Officer 206-838-2590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2012-12-27 |
| Last Update Date | 2021-05-27 |