Provider Demographics
NPI:1184736340
Name:ONCOLOGY GROUP PLLC
Entity type:Organization
Organization Name:ONCOLOGY GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:D
Authorized Official - Last Name:REGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-374-3915
Mailing Address - Street 1:512 N YOUNG ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7806
Mailing Address - Country:US
Mailing Address - Phone:509-374-3915
Mailing Address - Fax:509-374-8036
Practice Address - Street 1:7350 W DESCHUTES
Practice Address - Street 2:BUILDING A
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336
Practice Address - Country:US
Practice Address - Phone:509-737-3371
Practice Address - Fax:509-736-0958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7096357Medicaid
AB10170Medicare ID - Type Unspecified