Provider Demographics
NPI:1265456180
Name:GALLUCCI, JOHN J (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:GALLUCCI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3920 CAPITAL MALL DR SW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-8701
Mailing Address - Country:US
Mailing Address - Phone:360-753-4700
Mailing Address - Fax:360-753-6700
Practice Address - Street 1:121 N DIVISION ST
Practice Address - Street 2:SUITE 100
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-4918
Practice Address - Country:US
Practice Address - Phone:253-877-9333
Practice Address - Fax:253-887-0169
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2010-10-27
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Provider Licenses
StateLicense IDTaxonomies
WAMD000252452085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology