NPIMap

Organization Active NPI

Rainier Oncology Professional Services

  • Specialist
  • Puyallup, WA
National Provider Identifier
1164459442
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
RAINIER ONCOLOGY PROFESSIONAL SERVICES
Practice address
400 15TH Ave SE
Suite D
Puyallup, WA 98372-3750
Phone
(253) 697-4831
Fax
(253) 697-4818
NPI assigned
Jun 26, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Sibel Blau, MDNPI 1962490797
Title
President
Phone
(253) 697-4831

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

400 15TH Ave SE
Suite D
Puyallup, WA 98372-3750

Mailing address

400 15TH Ave SE
Suite D
Puyallup, WA 98372-3750
Phone (253) 697-4831

Other identifiers 2

IdentifierTypeStateIssuer
62944OtherWAL&I GROUP NUMBER
7048192MedicaidWA

National Provider Directory

National Provider Directory

Locations

1322 3rd St SE
#40
Puyallup, WA 98372
Phone (253) 841-4296

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164459442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 15TH AVE SE",
            "address_2": "SUITE D",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723750",
            "telephone_number": "253-697-4831",
            "fax_number": "253-697-4818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 15TH AVE SE",
            "address_2": "SUITE D",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723750",
            "telephone_number": "253-697-4831",
            "fax_number": "253-697-4818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINIER ONCOLOGY PROFESSIONAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLAU",
        "authorized_official_first_name": "SIBEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-697-4831",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I GROUP NUMBER",
            "identifier": "62944",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7048192",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.