Organization
PENINSULA RAD ONC CTR LLC
Active
Other names
TACOMA RAD ONC CTR INC MBR
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETTY SABLE (CFO)
(253) 779-6325
Entity
Organization
Contact information
Practice address
11511 CANTERWOOD BLVD STE 50, GIG HARBOR, WA 98332-5816
(253) 779-6325
(253) 627-8792
Mailing address
4230 BRIDGEPORT WAY W STE B, UNIVERSITY PLACE, WA 98466-4335
(253) 779-6325
(253) 627-8792
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7144793
—
WA
01
—
8949842
L&I CRIME VICTIMS
WA
Enumeration date
10/16/2008
Last updated
09/09/2020
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