Healthcare Provider Details

I. General information

NPI: 1881637569
Provider Name (Legal Business Name): WASHINGTON RADIATION ONCOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2109-C N. HAMILTON STREET
RICHMOND VA
23230
US

IV. Provider business mailing address

110 IRVING ST NW
WASHINGTON DC
20010-2976
US

V. Phone/Fax

Practice location:
  • Phone: 800-353-0788
  • Fax:
Mailing address:
  • Phone: 202-877-3925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: PAMELA RANDOLPH
Title or Position: OFFICE MANAGER
Credential: MD
Phone: 202-877-3925