Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
Proliance Orthopedic Associates 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
8009 S. 180TH STREET, SUITE 105, KENT, WA 98032-1042
(425) 656-0711
(425) 656-0344
Mailing address
4011 TALBOT RD S STE 300, RENTON, WA 98055-5791
(425) 656-5060
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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