Individual
RANDY BRIAN MANDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1740 NW MAPLE ST STE 100, ISSAQUAH, WA 98027
(425) 391-3900
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00036928
WA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
MD00036928
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841357381
—
WA
01
—
267860
INTERNAL ID-MOTOR VEHICLE ID
—
01
—
8882504
MEDICARE PIN
WA
Enumeration date
01/03/2007
Last updated
11/09/2018
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