Individual
RANDALL MATTHEW CHESNUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
HARBORVIEW MEDICAL CENTER, PBS BUILDING, 401 BROADWAY, #2075, SEATTLE, WA 98122
(206) 744-9340
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD00043532
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0230864
L&I
WA
05
—
1669515136
—
WA
01
—
2031370
INTERNAL ID-MOTOR VEHICLE ID
—
Enumeration date
02/15/2007
Last updated
02/16/2012
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