Individual
RANDY NEVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPHT
Contact information
Practice address
24135 SE 16TH PL, SAMMAMISH, WA 98075-8127
(425) 392-3827
Mailing address
24135 SE 16TH PL, SAMMAMISH, WA 98075-8127
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
VA60246492
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
560107010225038
CPHT CERTIFICATION NUMBER
WA
01
—
VA60246492
WA STATE CERTIFICATION NUMBER
WA
Enumeration date
09/15/2011
Last updated
09/15/2011
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