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Organization

PROLIANCE SURGEONS, INC., P.S.

Active
Other names
Proliance Orthopedic Associates
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LAURA KLEISLE (CHIEF RISK OFFICER)
(206) 838-2590
Entity
Organization

Contact information

Practice address
24060 SE KENT KANGLEY RD, MAPLE VALLEY, WA 98038-6851
(253) 358-7708
(425) 656-5047
Mailing address
4011 TALBOT RD S STE 300, RENTON, WA 98055-5791

Taxonomy

Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
207X00000X
Orthopaedic Surgery Physician
Primary
601484763
WA
2083X0100X
Occupational Medicine Physician
363AS0400X
Surgical Physician Assistant
363LF0000X
Family Nurse Practitioner

Other

Enumeration date
03/04/2015
Last updated
05/28/2021
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