Randolph, Daniel Lee

Randolph, Daniel Lee is an individual health care provider with primary practice located at 9631 N Nevada St Ste 100 , Spokane WA 99218-1134. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Randolph, Daniel Lee can be contacted via phone (509) 625-3760.

Contact Information

Primary practice address
9631 N Nevada St Ste 100 Spokane WA 99218-1134
Phone: (509) 625-3760
Fax: (509) 625-3789
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD00031792 Washington

Profile Details

NPI number 1205838992
LBN Legal business name Randolph, Daniel Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2005
Last updated May 4th, 2021 - about 3 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 1205838992 NPPES
Washington MEDICAID 1004773

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