Provider Demographics
NPI:1730412834
Name:VISTA ONCOLOGY INC PS
Entity type:Organization
Organization Name:VISTA ONCOLOGY INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINLI
Authorized Official - Middle Name:
Authorized Official - Last Name:XUAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-352-2900
Mailing Address - Street 1:141 LILLY RD NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5028
Mailing Address - Country:US
Mailing Address - Phone:360-413-8880
Mailing Address - Fax:360-350-4838
Practice Address - Street 1:410 BLACK HILLS LN SW
Practice Address - Street 2:SUITE C
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-8155
Practice Address - Country:US
Practice Address - Phone:360-413-8880
Practice Address - Fax:360-350-4838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-08
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty