PROLIANCE SURGEONS INC PS NPI 1780610220

NPI Information

PROLIANCE SURGEONS INC PS is an ambulatory surgical clinic center in Puyallup, WA. PROLIANCE SURGEONS INC PS NPI is 1780610220. The provider is registered as an organization entity type.
The provider Is Doing Business As Proliance Hillside Medical Surgery Center.

The provider's business location address is:

104 27TH AVE SE
PUYALLUP, WA
ZIP 98374-145
Phone: (253) 770-9000
Fax: (253) 770-9712

The provider's authorized official is Cori M. Pleasant .
The authorized official title is Del Cred & Enrollment Manager and has the following contact phone number (206) 838-2585.

The CLIA number assigned to this NPI record is 50D1042854 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/25/2006 and was last updated on 12/6/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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