Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
Skagit Northwest Orthopedics 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
1500 CONTINENTAL PL, MOUNT VERNON, WA 98273-4105
(360) 424-7041
(360) 424-2418
Mailing address
1401 S LAVENTURE RD, MOUNT VERNON, WA 98274-6033
(360) 424-7041
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
261QR0200X
Radiology Clinic/Center
—
—
Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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