Individual
ALICIA ANN RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
201 16TH AVE E, SEATTLE, WA 98112-5226
(206) 326-3000
(206) 326-2785
Mailing address
16083 SW UPPER BOONES FERRY RD, STE. 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00003418
WA
2251E1300X
Clinical Electrophysiology Physical Therapist
PT00003418
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0221473
WASHINGTON L&I
WA
05
—
1376678342
—
WA
05
—
8407082
—
WA
01
—
P00802476
RR MEDICARE
WA
Enumeration date
02/22/2007
Last updated
05/13/2021
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