# PROLIANCE SURGEONS, INC., P.S.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Proliance Orthopedic Associates MRI
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275102923
- **Authorized official:** MRS. LAURA KLEISLE (CHIEF RISK OFFICER)
- **Authorized official phone:** (206) 838-2590

## Contact information

- **Practice address:** 8009 S. 180TH STREET, SUITE 105, KENT, WA 98032-1042
- **Practice address phone:** (425) 656-0711
- **Practice address fax:** (425) 656-0344
- **Mailing address:** 4011 TALBOT RD S STE 300, RENTON, WA 98055-5791
- **Mailing address phone:** (425) 656-5060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 261QR0200X | Radiology Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 06/17/2021
- **Last updated:** 06/17/2021