# PENINSULA RAD ONC CTR LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** TACOMA RAD ONC CTR INC MBR
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366694796
- **Authorized official:** MRS. BETTY SABLE (CFO)
- **Authorized official phone:** (253) 779-6325

## Contact information

- **Practice address:** 11511 CANTERWOOD BLVD STE 50, GIG HARBOR, WA 98332-5816
- **Practice address phone:** (253) 779-6325
- **Practice address fax:** (253) 627-8792
- **Mailing address:** 4230 BRIDGEPORT WAY W STE B, UNIVERSITY PLACE, WA 98466-4335
- **Mailing address phone:** (253) 779-6325
- **Mailing address fax:** (253) 627-8792

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0001X | Radiation Oncology Physician | — | NULL | — |
| 2085R0001X | Radiation Oncology Physician | — | — | — |
| 261QR0200X | Radiology Clinic/Center | — | WA | Yes |

## Other

- **Enumeration date:** 10/16/2008
- **Last updated:** 09/09/2020