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Individual
RANDY E YOUNG
Active
Individual
RANDY E YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMP
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00020366
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193802
DEPT OF LABOR & INDUSTRY
WA
01
—
5652YO
REGENCE BLUE SHIELD
WA
01
—
8903882
CRIME VICTIMS
WA
Enumeration date
11/15/2006
Last updated
07/08/2007
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