Organization
RAINIER ONCOLOGY PROFESSIONAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SIBEL BLAU MD (PRESIDENT)
(253) 697-4831
Entity
Organization
Contact information
Practice address
400 15TH AVE SE, SUITE D, PUYALLUP, WA 98372-3750
(253) 697-4831
(253) 697-4818
Mailing address
400 15TH AVE SE, SUITE D, PUYALLUP, WA 98372-3750
(253) 697-4831
(253) 697-4818
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
62944
L&I GROUP NUMBER
WA
05
—
7048192
—
WA
Enumeration date
06/26/2006
Last updated
08/22/2020
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