Provider Demographics
NPI:1700990918
Name:WASHINGTON CANCER CENTERS PC
Entity Type:Organization
Organization Name:WASHINGTON CANCER CENTERS PC
Other - Org Name:PUGET SOUND CANCER CENTERS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-775-1677
Mailing Address - Street 1:1560 N 115TH ST
Mailing Address - Street 2:G-16
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-8414
Mailing Address - Country:US
Mailing Address - Phone:206-362-1577
Mailing Address - Fax:206-367-7176
Practice Address - Street 1:21605 76TH AVE W
Practice Address - Street 2:STE # 200
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7514
Practice Address - Country:US
Practice Address - Phone:425-775-1677
Practice Address - Fax:425-778-1635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7083371Medicaid