Individual
ALICIA ANN RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
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
Update your record
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