MEDICARE: ROBERT JAMES SOLLACCIO 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	122679	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942202981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT JAMES SOLLACCIO M.D.

Provider Business Mailing Address
First Line	:	PO BOX 3991
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98124-3991
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2250 S WOODWORTH LOOP STE 100
Second Line	:
City	:	PALMER
State	:	AK
Zip	:	99645-7457
Country	:	US
Telephone Number	:	907-707-1333
Fax Number	:	844-248-7515

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	05/21/2026

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