NPIMap

Organization Active NPI

Peninsula Cancer Center LLC

  • Radiation Oncology Physician
  • Poulsbo, WA
National Provider Identifier
1083857940
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
PENINSULA CANCER CENTER LLC
Practice address
19917 7TH Ave NE
Poulsbo, WA 98370-7403
Phone
(360) 697-8000
NPI assigned
Apr 8, 2009
Last updated
Jan 31, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Nezam Tooloee
Title
Authorized Official
Phone
(206) 755-1825

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X Primary

Addresses

Primary practice location

19917 7TH Ave NE
Poulsbo, WA 98370-7403

Mailing address

PO Box 742322
Los Angeles, CA 90074-2322
Phone (360) 697-8000

National Provider Directory

National Provider Directory

Locations

31163 File
San Francisco, CA 94160

19917 7th Ave NE
Poulsbo, WA 98370
Phone (206) 755-1825

1145 Broadway
Fl 2
Seattle, WA 98122
Phone (206) 860-3509

558 N 5th Ave
Sequim, WA 98382
Phone (360) 681-6900

844 N 5th Ave
Sequim, WA 98382
Phone (360) 683-9895

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1239148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485820800000",
    "number": "1083857940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742322",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900742322",
            "telephone_number": "360-697-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19917 7TH AVE NE",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707403",
            "telephone_number": "360-697-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA CANCER CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-08",
        "last_updated": "2017-01-31",
        "status": "A",
        "authorized_official_last_name": "TOOLOEE",
        "authorized_official_first_name": "NEZAM",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "206-755-1825"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poulsbo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.