Healthcare Provider Details

I. General information

NPI: 1649895194
Provider Name (Legal Business Name): GRASS VALLEY RADIATION ONCOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2020
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 GLASSON WAY BLDG 3L-20
GRASS VALLEY CA
95945-5723
US

IV. Provider business mailing address

PO BOX 24132
SEATTLE WA
98124-0132
US

V. Phone/Fax

Practice location:
  • Phone: 407-788-1906
  • Fax: 407-682-4844
Mailing address:
  • Phone: 800-329-1906
  • Fax: 407-682-4844

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: DR. CLAYTON B HESS
Title or Position: OWNER
Credential: MD
Phone: 678-733-5626