MEDICARE: ALEXEI L POLISHCHUK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician	MD60636309	WA

General Provider Information

NPI Number	:	1295021921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXEI L POLISHCHUK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 60671
Second Line	:
City	:	CITY OF INDUSTRY
State	:	CA
Zip	:	91716-0671
Country	:	US
Telephone Number	:	360-370-2873
Fax Number	:	360-818-2873

Provider Business Practice Location Address
First Line	:	381 W HORTON RD
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98226-7740
Country	:	US
Telephone Number	:	360-370-2873
Fax Number	:	360-818-2873

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2011
Last Update Date	:	10/08/2025

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