PENINSULA RAD ONC CTR LLC NPI 1366694796

NPI Information

NPI: 1366694796
Provider Name: PENINSULA RAD ONC CTR LLC
Classification: Clinic/Center - 261QR0200X
Specialization: Radiology
Entity Type: Organization
Other Name: TACOMA RAD ONC CTR INC MBR
Address: 11511 CANTERWOOD BLVD STE 50
GIG HARBOR, WA
ZIP 98332
Phone: (253) 779-6325

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NPI Details

PENINSULA RAD ONC CTR LLC is a radiology clinic center in Gig Harbor, WA. PENINSULA RAD ONC CTR LLC NPI is 1366694796. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Tacoma Rad Onc Ctr Inc Mbr.

The provider's business location address is:

11511 CANTERWOOD BLVD STE 50
GIG HARBOR, WA
ZIP 98332-816
Phone: (253) 779-6325
Fax: (253) 627-8792

The provider's authorized official is Betty Sable .
The authorized official title is Cfo and has the following contact phone number (253) 779-6325.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

Ct guidance for insertion of radiation therapy fields (HCPCS:77014)
Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session (HCPCS:G6015)
Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 6-10 mev (HCPCS:G6012)
Continuing radiation therapy consultation per week (HCPCS:77336)
Calculation of radiation therapy dose (HCPCS:77300)
Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 11-19 mev (HCPCS:G6013)
Design and construction of complex radiation treatment device (HCPCS:77334)
Obtaining data needed to develop the optimal radiation treatment, 1 treatment area (HCPCS:77280)
Design and construction of radiation treatment device for high precision radiation therapy (HCPCS:77338)
High precision radiation therapy planning (HCPCS:77301)
Obtaining data needed to develop the optimal radiation treatment, 3 or more treatment areas or any number of treatment areas where special treatment is involved (HCPCS:77290)
3d radiation therapy planning (HCPCS:77295)

The enumeration date for this NPI number is 10/16/2008 and was last updated on 9/9/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0001X	Radiology	Radiation Oncology			No
2	261QR0200X	Clinic/Center	Radiology		WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7144793	MEDICAID	WASHINGTON
2	8949842	OTHER	WASHINGTON	L&I CRIME VICTIMS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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