Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
Orthopedic Physician Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA KLEISLE (CHIEF RISK OFFICER)
(206) 838-2590
Entity
Organization
Contact information
Practice address
3216 NE 45TH PL STE 304, SEATTLE, WA 98105-4028
(206) 386-2600
(206) 622-1644
Mailing address
601 BROADWAY FL 6, SEATTLE, WA 98122-5330
(206) 386-2600
(206) 622-1644
Taxonomy
Speciality
Code
Description
License number
State
2080S0010X
Pediatric Sports Medicine Physician
Primary
601484763
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2021639
—
WA
01
—
49701
WA LABOR & INDUSTRIES
WA
Enumeration date
04/02/2015
Last updated
05/27/2021
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