Individual
DANIEL LEE RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9631 N NEVADA ST STE 100, SPOKANE, WA 99218-1134
(509) 625-3760
(509) 625-3789
Mailing address
9631 N NEVADA ST STE 100, SPOKANE, WA 99218-1134
(509) 625-3760
(509) 625-3789
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00031792
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004773
—
WA
Enumeration date
08/11/2005
Last updated
05/04/2021
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