Organization
PROLIANCE SURGEONS, INC., P.S.
Active
Other names
Puget Sound Imaging 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
1724 W. UNION AVENUE, SUITE B-100, TACOMA, WA 98405-2099
(253) 830-5215
(253) 830-5219
Mailing address
7308 BRIDGEPORT WAY W STE 201, LAKEWOOD, WA 98499-8000
(253) 582-7257
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
261QR0200X
Radiology Clinic/Center
—
—
Other
Enumeration date
06/17/2021
Last updated
07/09/2021
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