Bennett, Randall Paul

Bennett, Randall Paul is an individual health care provider with primary practice located at 104 27Th Ave Se , Puyallup WA 98374-1145. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Bennett, Randall Paul can be contacted via phone (253) 770-9000.

Contact Information

Primary practice address
104 27Th Ave Se Puyallup WA 98374-1145
Fax: (253) 770-9712
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X MD22922 Washington

Profile Details

NPI number 1619907953
LBN Legal business name Bennett, Randall Paul
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Oct 20th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619907953 NPPES
Washington MEDICAID 7078017

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