Organization
PACIFIC ONCOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM M MOONEY MD (PRESIDENT, CEO)
(503) 203-1000
Entity
Organization
Contact information
Practice address
15700 SW GREYSTONE CT, BEAVERTON, OR 97006-6011
(503) 203-1000
(503) 203-1010
Mailing address
PO BOX 3378, PORTLAND, OR 97208-3378
(503) 203-1000
(503) 203-1000
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
2085R0001X
Radiation Oncology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130430
—
OR
05
—
7084056
—
WA
01
—
CV0082
RR MEDICARE GROUP NUMBER
OR
Enumeration date
05/17/2006
Last updated
02/13/2008
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