Provider Demographics
NPI:1376646794
Name:COLUMBIA BASIN HEMATOLOGY & ONCOLOGY PLLC
Entity Type:Organization
Organization Name:COLUMBIA BASIN HEMATOLOGY & ONCOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:RADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-783-0144
Mailing Address - Street 1:7360 W DESCHUTES AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7774
Mailing Address - Country:US
Mailing Address - Phone:509-783-0144
Mailing Address - Fax:509-783-8244
Practice Address - Street 1:7360 W DESCHUTES AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7774
Practice Address - Country:US
Practice Address - Phone:509-783-0144
Practice Address - Fax:509-783-8244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7092901Medicaid
WA7092901Medicaid
WA6523930001Medicare NSC