Fish, Randolph Charles

Fish, Randolph Charles is an sole proprietor health care provider with primary practice located at 915 So. 76Th St. , Tacoma WA 98408-2902. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Foot Surgery. Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine is his primary health care specialty. Fish, Randolph Charles can be contacted via phone (253) 584-9530.

Contact Information

Primary practice address
915 So. 76Th St. Tacoma WA 98408-2902
Phone: (253) 584-9530
Fax: (360) 427-2769
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X 91-1813864 Washington
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X PO00000297 Washington

Profile Details

NPI number 1063493559
LBN Legal business name Fish, Randolph Charles
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 10th, 2005
Last updated Apr 8th, 2016 - about 8 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 1063493559 NPPES
Washington MEDICAID 2041494
Washington MEDICAID 2041490

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