# PROLIANCE SURGEONS, INC., P.S.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SEATTLE OBSTETRICS & GYNECOLOGY GROUP
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740727106
- **Authorized official:** MRS. LAURA KLEISLE (CHIEF RISK OFFICER)
- **Authorized official phone:** (206) 838-2590

## Contact information

- **Practice address:** 1101 MADISON ST STE 950, SEATTLE, WA 98104-3592
- **Practice address phone:** (206) 682-5800
- **Practice address fax:** (206) 233-9657
- **Mailing address:** 1101 MADISON ST STE 950, SEATTLE, WA 98104-3592
- **Mailing address phone:** (206) 682-5800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 601484763 | WA | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 363LW0102X | Women's Health Nurse Practitioner | — | NULL | — |
| 363LW0102X | Women's Health Nurse Practitioner | — | — | — |
| 363LX0001X | Obstetrics & Gynecology Nurse Practitioner | — | NULL | — |
| 363LX0001X | Obstetrics & Gynecology Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 01/24/2017
- **Last updated:** 05/28/2021