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Individual

LINDA SUE RANDALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
404 E 26TH ST STE 103, TACOMA, WA 98421-1312
(253) 906-4688
Mailing address
404 E 26TH ST STE 103, TACOMA, WA 98421-1312
(253) 906-4688

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00017283
WA

Other

Enumeration date
09/25/2008
Last updated
09/25/2008
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