Individual
RANDY DIMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
33 S WAVERLY ST, KENNEWICK, WA 99336-3275
(509) 430-5668
Mailing address
33 S WAVERLY ST, KENNEWICK, WA 99336-3275
(509) 430-5668
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00047844
WA
Other
Enumeration date
11/24/2014
Last updated
11/24/2014
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