Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
NORTHWEST WOMEN'S HEALTHCARE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA KLEISLE (CHIEF RISK OFFICER)
(206) 838-2590
Entity
Organization
Contact information
Practice address
1101 MADISON ST STE 1150, SEATTLE, WA 98104-3558
(206) 386-3400
(206) 386-3411
Mailing address
1101 MADISON ST STE 1150, SEATTLE, WA 98104-3558
(206) 386-3400
(206) 386-3411
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
601484763
WA
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2074883
—
WA
Enumeration date
01/10/2017
Last updated
05/27/2021
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