Healthcare Provider Details
I. General information
NPI: 1841450301
Provider Name (Legal Business Name): VISTA ONCOLOGY INC PS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2008
Last Update Date: 05/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
141 LILLY RD NE
OLYMPIA WA
98506-5028
US
IV. Provider business mailing address
141 LILLY RD NE
OLYMPIA WA
98506-5028
US
V. Phone/Fax
- Phone: 360-413-8880
- Fax: 888-629-7609
- Phone: 360-413-8880
- Fax: 888-629-7609
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOSEPH
ZHOU
YE
Title or Position: PRESIDENT
Credential: MD
Phone: 360-352-2900