Individual
RANDALL LEE DE JONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
916 PACIFIC AVE, 1 SOUTH, EVERETT, WA 98201-4147
(425) 258-7390
(425) 258-7379
Mailing address
909 N BROADWAY, PBO, EVERETT, WA 98201-1409
(425) 317-0699
(425) 317-0291
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP30004081
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9631052
—
WA
Enumeration date
10/20/2006
Last updated
11/07/2025
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