| NPI | 1669411617 |
|---|---|
| Doing Business As | PROLIANCE PROORTHO ORTHOPEDICS SPORTS, JOINTS AND SPINE |
| Entity Type | Organization |
| Authorized Contact | CORI M. PLEASANT Mgr Provider Relations/Enrollment 206-838-2585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA 601484763) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363AS0400X Physician Assistant Surgical | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2022-08-22 |