Proliance Eastside Ent is a
Ophthalmology based in Redmond, Washington. Proliance Eastside Ent is licensed to practice in * (Not Available) (license number ) and their current practice location is
17130 Avondale Way Ne Ste 111, Redmond, Washington. It can be reached at their office (for appointments etc.) via phone at
(425) 885-6600.
NPI number for Proliance Eastside Ent is 1275726739 and their current mailing address is 17130 Avondale Way Ne Ste 111, Redmond, Washington. Proliance Eastside Ent
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1275726739.
Healthcare Provider's Profile
| Full Name | Proliance Eastside Ent |
|---|
| Type | Facility |
|---|
| Speciality | Ophthalmology |
|---|
| Location | 17130 Avondale Way Ne Ste 111, Redmond, Washington |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1275726739
- Provider Enumeration Date: 08/19/2007
- Last Update Date: 05/02/2025
Medical Identifiers
Medical identifiers for Proliance Eastside Ent such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1275726739 | NPI | - | NPPES |
| 222338 | Other | WA | WA LABOR & INDUSTRIES |
| 2001403 | Medicaid | WA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Primary |
| 207Y00000X | Otolaryngology | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Proliance Eastside Ent is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Proliance Eastside Ent
17130 Avondale Way Ne Ste 111,
Redmond, WA 98052-4455
Ph: (425) 885-6600 | Proliance Eastside Ent
17130 Avondale Way Ne Ste 111,
Redmond, WA 98052-4455
Ph: (425) 885-6600 |
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