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General NPI Number Information
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NPI Number | 1558300434
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Entity Type | Organization
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Legal Business Name | PROLIANCE SURGEONS INC., P.S.
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 06/17/2021
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Provider Practice Location Address
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Address Line | 601 BROADWAY FL 6
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City | SEATTLE
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State | WA
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Zip | 98122-5330
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Country | US
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Telephone | 206-386-2600
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Fax | 206-622-1644
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Provider Business Mailing Address
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Address Line | 601 BROADWAY FL 6
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City | SEATTLE
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State | WA
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Zip | 98122-5330
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Country | US
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Telephone | 206-386-2600
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Fax | 206-622-1644
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Authorized Official
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Title or Position | CHIEF RISK OFFICER
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Name | MRS. LAURA KLEISLE
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Credential |
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Telephone | 206-838-2590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2471M1202X
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Taxonomy Name | Magnetic Resonance Imaging Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 601484763
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License Number State | WA
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Taxonomy #9
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 601484763
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License Number State | WA
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Taxonomy #10
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 601484763
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License Number State | WA
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Taxonomy #11
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 601484763
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License Number State | WA
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