Fuller, Randelle K
Fuller, Randelle K is an individual health care provider with primary practice located at 965 Goethals Dr , Richland WA 99352-3527. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Fuller, Randelle K can be contacted via phone (509) 460-5588.Contact Information
Primary practice address
965 Goethals Dr
Richland WA 99352-3527
Phone: (509) 460-5588
Fax: (509) 783-5438
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT00010472 | Washington |
Profile Details
| NPI number | 1023237120 |
|---|---|
| LBN Legal business name | Fuller, Randelle K |
| Credentials | Master of Physical Therapy (MPT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 25th, 2007 |
| Last updated | Aug 2nd, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023237120 | NPPES |
| Washington | MEDICAID | 2043848 | |
| Washington | Other | 339545 |
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