Provider Demographics
NPI:1497083331
Name:ONCOLOGY SERVICES PLLC
Entity Type:Organization
Organization Name:ONCOLOGY SERVICES PLLC
Other - Org Name:MICHAEL L BROWN MD.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLERK
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:PEDERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-525-2220
Mailing Address - Street 1:PO BOX 481
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-0013
Mailing Address - Country:US
Mailing Address - Phone:509-525-2220
Mailing Address - Fax:509-525-4878
Practice Address - Street 1:401 W POPLAR ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-2846
Practice Address - Country:US
Practice Address - Phone:509-522-5700
Practice Address - Fax:509-525-4878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-04
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000289342085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1109297Medicaid
WA0187354OtherLABOR AND INDUSTRIES
OR034186Medicaid
WAF04593Medicare UPIN
WAGAB12190Medicare PIN