Organization
PROLIANCE SURGEONS INC., P.S.
Active
Organization
PROLIANCE SURGEONS INC., P.S.
Active
Other names
Northwest Orthopaedic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA KLEISLE (CHIEF RISK OFFICER)
(206) 838-2590
Entity
Organization
Contact information
Practice address
9730 3RD AVE NE STE 201, SEATTLE, WA 98115-2023
(206) 526-8444
(206) 526-0521
Mailing address
9730 3RD AVE NE STE 201, SEATTLE, WA 98115-2023
(206) 526-8444
(206) 526-0521
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
601484763
WA
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1042992
—
WA
01
—
49385
WA LABOR & INDUSTRIES
WA
Enumeration date
06/05/2006
Last updated
05/27/2021
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