Provider Demographics
NPI:1063480358
Name:FOXLEE, RICHARD HEATH (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HEATH
Last Name:FOXLEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PENINSULA CANCER CENTER LLC
Mailing Address - Street 2:PO BOX 742322
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-2322
Mailing Address - Country:US
Mailing Address - Phone:360-697-8000
Mailing Address - Fax:360-598-6227
Practice Address - Street 1:19917 7TH AVE NE
Practice Address - Street 2:SUITE 100
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-6555
Practice Address - Country:US
Practice Address - Phone:360-697-8000
Practice Address - Fax:360-598-6227
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000275062085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00233281OtherRAILROAD MEDICARE
2308OLOtherREGENCE BLUE SHIELD RIDER
WA8118911Medicaid
WA8118911Medicaid
8854455Medicare ID - Type Unspecified