Provider Demographics
NPI:1184632572
Name:TUMOR INSTITUTE RADIATION ONCOLOGY GROUP LLP
Entity Type:Organization
Organization Name:TUMOR INSTITUTE RADIATION ONCOLOGY GROUP LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MONAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-320-7129
Mailing Address - Street 1:PO BOX 749730
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-9730
Mailing Address - Country:US
Mailing Address - Phone:888-709-4485
Mailing Address - Fax:302-733-0854
Practice Address - Street 1:1221 MADISON ST
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3589
Practice Address - Country:US
Practice Address - Phone:206-386-2323
Practice Address - Fax:206-385-6150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACS0846OtherRAILROAD MEDICARE-PALMETTO GBA
WA7805203Medicaid
WA000178900Medicare PIN