Proliance Retina
LBN: Proliance Surgeons, Inc., P.S.
Proliance Retina is an health care organization with primary practice located at 1750 112Th Ave Ne Ste D050 , Bellevue WA 98004. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist, Ambulatory Health Care Facilities / Multi-Specialty. Allopathic & Osteopathic Physicians / Ophthalmology is the primary health care specialty.
Proliance Surgeons, Inc., P.S. can be contacted via phone (206) 215-3850, or through Kleisle, Laura via phone (206) 838-2590.
Contact Information
Primary practice address
1750 112Th Ave Ne Ste D050
Bellevue WA 98004
Phone: (206) 215-3850
Fax: (206) 215-3870
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 601484763 | Washington |
Allopathic & Osteopathic Physicians / Retina Specialist | 207WX0107X | 601484763 | Washington |
Ambulatory Health Care Facilities / Multi-Specialty | 261QM1300X | 601484763 | Washington |
Profile Details
NPI number | 1841568946 |
---|---|
LBN Legal business name | Proliance Surgeons, Inc., P.S. |
DBA Doing business as | Proliance Retina |
Authorized official | Kleisle, Laura |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Dec 5th, 2011 |
Last updated | May 28th, 2021 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1841568946 | NPPES |
Washington | MEDICAID | 2016220 | |
Washington | Other | 288391 |
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