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Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
Proliance Orthopedic Associates MRI
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA KLEISLE (CHIEF RISK OFFICER)
(206) 838-2590
Entity
Organization
Contact information
Practice address
8009 S. 180TH STREET, SUITE 105, KENT, WA 98032-1042
(425) 656-0711
(425) 656-0344
Mailing address
4011 TALBOT RD S STE 300, RENTON, WA 98055-5791
(425) 656-5060
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
NULL
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
NULL
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
—
NULL
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
NULL
261QR0200X
Radiology Clinic/Center
—
NULL
Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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