Individual
MR. RANDOLPH CHARLES FISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
915 SO. 76TH ST., TACOMA, WA 98408-2902
(253) 584-9530
(360) 427-2769
Mailing address
915 SO. 76TH ST, TACOMA, WA 98408-2902
(253) 584-9530
(360) 427-2769
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
91-1813864
WA
213ES0131X
Foot Surgery Podiatrist
PO00000297
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2041490
—
WA
05
—
2041494
—
WA
Enumeration date
11/10/2005
Last updated
04/08/2016
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