NPIMap

Organization Active NPI

Monday, July 02, 2018

  • Hematology & Oncology Physician
  • Olympia, WA
National Provider Identifier
1902457211
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
MONDAY, JULY 02, 2018
Practice address
3920 Capital Mall Dr SW Ste 100
Olympia, WA 98502-8701
Phone
(360) 345-1382
Fax
(360) 345-1382
NPI assigned
Sep 27, 2019
Last updated
Sep 27, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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

Authorized official

Name
Lucio Navarro GordanNPI 1346235975
Title
Owner/President
Phone
(239) 274-8200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X NU
Hematology & Oncology Physician 207RH0003X NU Primary
Medical Oncology Physician 207RX0202X NU

Addresses

Primary practice location

3920 Capital Mall Dr SW Ste 100
Olympia, WA 98502-8701

Mailing address

9160 Forum Corporate Pkwy Ste 350
Fort Myers, FL 33905-7808
Phone (239) 785-3200

National Provider Directory

National Provider Directory
Tax ID family
American Oncology Partners PA157 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 6

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569542400000",
    "number": "1902457211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9160 FORUM CORPORATE PKWY STE 350",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057808",
            "telephone_number": "239-785-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 CAPITAL MALL DR SW STE 100",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028701",
            "telephone_number": "360-345-1382",
            "fax_number": "360-345-1382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONDAY, JULY 02, 2018",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-27",
        "last_updated": "2019-09-27",
        "status": "A",
        "authorized_official_last_name": "GORDAN",
        "authorized_official_first_name": "LUCIO",
        "authorized_official_middle_name": "NAVARRO",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "239-274-8200"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; 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.