Individual
RANDY A NOTEBLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
904 7TH AVE, SEATTLE, WA 98104-1132
(206) 223-6487
Mailing address
1100 OLIVE WAY MSC M4-PA, SEATTLE, WA 98101-1873
(206) 515-5811
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
PT00003291
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039585
LABOR AND INDUSTRIES #
WA
05
—
8342677
—
WA
01
—
NO5497
BLUE SHIELD #
WA
01
—
P00079877
RAILROAD MEDICARE
WA
01
—
US1051973
AETNA SPECIALIST PIN
WA
Enumeration date
01/30/2007
Last updated
04/09/2008
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