Peninsula Cancer Center LLC
in Poulsbo, WA. Organization (NPI-2).
NPI number1083857940
StatusActive
Last updated in NPPESJan 31, 2017
Details
- NPI
- 1083857940
- Entity type
- Organization (NPI-2)
- Legal business name
- Peninsula Cancer Center LLC
- Organization subpart
- No
- Enumeration date
- Apr 8, 2009
- Last updated
- Jan 31, 2017
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0001X | – | – | Yes |
Practice location
19917 7th Ave NePoulsbo, WA 98370-7403
Phone 360-697-8000
Mailing address
Po Box 742322Los Angeles, CA 90074-2322
Phone 360-697-8000
Authorized official
Nezam Tooloee
Authorized Official
2067551825
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