Organization
PROLIANCE SURGEONS INC., P.S.
Active
Other names
Orthopedic Physician Associates, Orthopedic Physician 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
601 BROADWAY FL 6, SEATTLE, WA 98122-5330
(206) 386-2600
(206) 622-1644
Mailing address
601 BROADWAY FL 6, SEATTLE, WA 98122-5330
(206) 386-2600
(206) 622-1644
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
601484763
WA
207Q00000X
Family Medicine Physician
601484763
WA
207X00000X
Orthopaedic Surgery Physician
Primary
601484763
WA
207XS0117X
Orthopaedic Surgery of the Spine Physician
601484763
WA
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2021639
—
WA
01
—
49701
WA L&I
WA
Enumeration date
06/06/2006
Last updated
06/17/2021
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