Basic Information
Provider Information
NPI: 1063678514
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ASHTON
FirstName: SPENCER
MiddleName: N
NamePrefix: DR.
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 34439
Address2:  
City: SEATTLE
State: WA
PostalCode: 981241439
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 401 W POPLAR ST
Address2: RADIATION ONCOLOGY
City: WALLA WALLA
State: WA
PostalCode: 993622846
CountryCode: US
TelephoneNumber: 5095225700
FaxNumber: 5095225515
Other Information
ProviderEnumerationDate: 08/04/2008
LastUpdateDate: 03/20/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0001XMD60226451WAY Allopathic & Osteopathic PhysiciansRadiologyRadiation Oncology

ID Information
IDTypeStateIssuerDescription
106367851405WA MEDICAID
50063685005OR MEDICAID


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