Basic Information
| Provider Information | |||||||||
| NPI: | 1285168872 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RADIATION ONCOLOGY SPECIALISTS PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19250 SW 65TH AVE | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | TUALATIN | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970627452 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5035427687 | ||||||||
| FaxNumber: | 5036927903 | ||||||||
| Practice Location | |||||||||
| Address1: | 19250 SW 65TH AVE | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | TUALATIN | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970627452 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036925650 | ||||||||
| FaxNumber: | 5036927903 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2017 | ||||||||
| LastUpdateDate: | 08/29/2017 | ||||||||
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| AuthorizedOfficialLastName: | FUSS | ||||||||
| AuthorizedOfficialFirstName: | MARTIN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 9712356452 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QX0203X | MD169914 | OR | Y | Ambulatory Health Care Facilities | Clinic/Center | Oncology, Radiation |
No ID Information.