Healthcare Provider Details

I. General information

NPI: 1609202282
Provider Name (Legal Business Name): RBS EVOLUTION OF JUNEAU LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2013
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 SALMON CREEK RD
JUNEAU AK
99801
US

IV. Provider business mailing address

PO BOX 84923
SEATTLE WA
98124-6223
US

V. Phone/Fax

Practice location:
  • Phone: 907-586-7762
  • Fax:
Mailing address:
  • Phone: 615-746-4711
  • Fax: 615-296-0952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL MOORE
Title or Position: ADMINISTRATOR
Credential:
Phone: 615-746-4711