Individual
RANDALL A BLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1959 NE PACIFIC ST, BOX 356161, NE-306, SEATTLE, WA 98195-0001
(206) 598-4022
Mailing address
14015 36TH AVE NE, SEATTLE, WA 98125-3725
(440) 241-0706
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
MD60671186
WA
Other
Enumeration date
03/23/2009
Last updated
09/19/2016
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