Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
Puyallup Ambulatory Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA KLEISLE (CHIEF RISK OFFICER)
(206) 838-2590
Entity
Organization
Contact information
Practice address
1519 3RD ST SE, SUITE 240, PUYALLUP, WA 98372-3742
(253) 445-1844
Mailing address
1519 3RD ST SE STE 210, PUYALLUP, WA 98372-3742
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2041039
—
WA
01
—
334863
WA LABOR & INDUSTRIES
WA
Enumeration date
08/04/2006
Last updated
05/27/2021
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