Organization
PROLIANCE SURGEONS, INC., P.S
Active
Other names
Edmonds Orthopedic 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
6808 220TH ST SW STE 200, MOUNTLAKE TERRACE, WA 98043-2187
(425) 967-6480
(425) 967-6485
Mailing address
805 MADISON ST STE 901, SEATTLE, WA 98104-1172
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
601484763
WA
207XS0106X
Orthopaedic Hand Surgery Physician
601484763
WA
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
601484763
WA
207XS0117X
Orthopaedic Surgery of the Spine Physician
601484763
WA
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
601484763
WA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
601484763
WA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
601484763
WA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
Other
Enumeration date
08/17/2017
Last updated
07/21/2022
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