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General NPI Number Information
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NPI Number | 1033289152
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Entity Type | Organization
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Legal Business Name | WESTERN WASHINGTON ONCOLOGY
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1800 COOKS HILL RD SUITE F
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City | CENTRALIA
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State | WA
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Zip | 98531-9072
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Country | US
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Telephone | 360-330-8939
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Fax |
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Provider Business Mailing Address
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Address Line | 4525 3RD AVE SE SUITE 200
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City | LACEY
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State | WA
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Zip | 98503-1010
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Country | US
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Telephone | 360-754-3934
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MELODY EDGINGTON
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Credential |
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Telephone | 360-754-3934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | WA
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