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Organization

PROLIANCE SURGEONS, INC., P.S.

Active
Other names
SEATTLE OBSTETRICS & GYNECOLOGY GROUP
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 950, SEATTLE, WA 98104-3592
(206) 682-5800
(206) 233-9657
Mailing address
1101 MADISON ST STE 950, SEATTLE, WA 98104-3592
(206) 682-5800

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
601484763
WA
207V00000X
Obstetrics & Gynecology Physician
Primary
261QM1300X
Multi-Specialty Clinic/Center
363LW0102X
Women's Health Nurse Practitioner
363LX0001X
Obstetrics & Gynecology Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2075030
WA
Enumeration date
01/24/2017
Last updated
05/28/2021
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