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PLASTIC & RECONSTRUCTIVE SURGEONS ASC
NPI 1316109309
Clinic/Center - Ambulatory Surgical in Renton, WA

Active since June 30, 2008CLIA 50D2097075 · Waiver
17930 TALBOT RD S, RENTON, WA 98055(425) 228-3187(425) 228-7972 Get Directions Write a Review

NPPES record last updated: May 27, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Plastic & Reconstructive Surgeons Asc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PLASTIC & RECONSTRUCTIVE SURGEONS ASC (NPI 1316109309) is a healthcare organization registered as an ambulatory surgical in Renton, Washington and active in the NPI registry since June 2008. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Laura Kleisle, Chief Risk Officer, as its authorized official.

NPPES Registry Identity

NPI1316109309
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NamePROLIANCE SURGEONS INC PS
Location Address17930 TALBOT RD SRenton, WA 98055-6230
Mailing Address17930 Talbot Rd SRenton, WA 98055-6230 · (425) 228-3187 · Fax (425) 228-7972
Phone(425) 228-3187
Fax(425) 228-7972
Organization SubpartNo
Authorized OfficialLaura KleisleChief Risk Officer · (206) 838-2590
Enumeration DateJune 30, 2008
Last NPPES UpdateMay 27, 2021
NPPES CertifiedMay 27, 2021
✔ NPI 1316109309 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
17930 TALBOT RD S, Renton, WA 98055
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Other Names 1

Doing Business AsPlastic & Reconstructive Surgeons Asc

Other Identifiers 1

Other344913WA · Wa Labor & Industries

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D2097075

Plastic And Reconstructive Surgeons ASC · Renton, WA
Active · expires Apr 4, 2028
CLIA Number50D2097075
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateJune 8, 2015
Certificate Expiration DateApril 4, 2028
Laboratory DirectorJonathan Hutter
Laboratory Phone(425) 228-3187
Laboratory LocationPlastic And Reconstructive Surgeons ASC17930 Talbot Rd S, Renton, WA 98055
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHAD MICHAEL BAILEY MD
Plastic Surgery
17930 TALBOT RD S
RENTON, WA 98055
King County (425) 228-3187
DR. WALLACE HAN JEN CHANG M.D.
Surgery (Plastic and Reconstructive Surgery)
17930 TALBOT RD S
RENTON, WA 98055
King County (425) 228-3187
BAILEY NICOLE PLATT ARNP
Nurse Practitioner
17930 TALBOT RD S
RENTON, WA 98055
King County (425) 228-3187
DR. TRENTON MATTHEW MORTON M.D.
Plastic Surgery
17930 TALBOT RD S
RENTON, WA 98055
King County (425) 228-3187
DR. JONATHAN JAMES HUTTER M.D.
Surgery (Plastic and Reconstructive Surgery)
17930 TALBOT RD S
RENTON, WA 98055
King County (425) 228-3187
GRACE T UM MD
Surgery (Plastic and Reconstructive Surgery)
17930 TALBOT RD S
RENTON, WA 98055
King County (425) 228-3187
DR. DAVID TETER BARKER M.D.
Surgery (Plastic and Reconstructive Surgery)
17930 TALBOT RD S
RENTON, WA 98055
King County (425) 228-3187
PROLIANCE SURGEONS, INC., P.S.
Plastic Surgery
17930 TALBOT RD S
RENTON, WA 98055
King County (425) 228-3187

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Proliance Surgeons Inc Ps's NPI number?

The NPI number for Proliance Surgeons Inc Ps is 1316109309. It was assigned to this organization in the NPPES registry on June 30, 2008. The provider is doing business as Plastic & Reconstructive Surgeons ASC.

Where is Proliance Surgeons Inc Ps located?

Proliance Surgeons Inc Ps is located at 17930 Talbot Rd S, Renton, WA 98055. The listed phone number is (425) 228-3187.

What is Proliance Surgeons Inc Ps's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Proliance Surgeons Inc Ps hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2097075) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Proliance Surgeons Inc Ps accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Proliance Surgeons Inc Ps as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Proliance Surgeons Inc Ps was last updated on May 27, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.