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Individual
RANDAL CURTIS CUPP
Active
Individual
RANDAL CURTIS CUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10003464
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0225542
STATE L&I
WA
01
—
0302340
STATE L&I
WA
05
—
8498388
—
WA
01
—
8945631
STATE CRIME VICTIMS
WA
01
—
P00704522
RAILROAD
WA
Enumeration date
10/09/2007
Last updated
12/15/2021
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