Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
Proliance Eastside 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
12911 120TH AVE NE, SUITE H-120, KIRKLAND, WA 98034-3027
(425) 823-4226
(425) 823-4754
Mailing address
12911 120TH AVE NE STE G10, KIRKLAND, WA 98034-3048
(425) 481-6301
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
06/05/2006
Last updated
05/27/2021
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