Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
SKAGIT NORTHWEST ORTHOPEDICS ASC AT CONTINENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA KLEISLE (CHIEF RISK OFFICER)
(206) 838-2590
Entity
Organization
Contact information
Practice address
1500 CONTINENTAL PL, MOUNT VERNON, WA 98273-4105
(360) 424-7041
(360) 424-2418
Mailing address
1401 S LAVENTURE RD, MOUNT VERNON, WA 98274-6033
(360) 424-7041
(360) 424-2418
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
601 484 763
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2033491
—
WA
01
—
332935
WA LABOR & INDUSTRIES
WA
Enumeration date
07/19/2005
Last updated
05/27/2021
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