Provider Demographics
NPI:1104048594
Name:PARTNER ONCOLOGY INC
Entity type:Organization
Organization Name:PARTNER ONCOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:XINSHENG
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:LIAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:253-770-1700
Mailing Address - Street 1:1519 3RD ST SE
Mailing Address - Street 2:SUITE 260
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372
Mailing Address - Country:US
Mailing Address - Phone:253-770-1700
Mailing Address - Fax:253-770-1702
Practice Address - Street 1:1519 3RD ST SE
Practice Address - Street 2:SUITE 260
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372
Practice Address - Country:US
Practice Address - Phone:253-770-1700
Practice Address - Fax:253-770-1702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WABL07-00297261QX0200X
207RH0003X
WAMD00036160207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1123850Medicaid
WA6272090001Medicare NSC
WAH15029Medicare UPIN