Individual
RANDI LYNNE SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, ARNP
Contact information
Practice address
401 15TH AVE SE, PUYALLUP, WA 98372-3715
(253) 697-4000
Mailing address
PO BOX 5299, TACOMA, WA 98415-0299
(253) 459-8231
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP61440380
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2268696
—
WA
Enumeration date
06/14/2023
Last updated
01/27/2025
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