Individual
RANDALL SHANE CLOWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
911 S WASHINGTON ST, SUITE A, KENNEWICK, WA 99336-5600
(509) 586-8368
Mailing address
911 S WASHINGTON ST, SUITE A, KENNEWICK, WA 99336-5600
(509) 586-8368
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
PA10003813
WA
363AM0700X
Medical Physician Assistant
Primary
PA10003813
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0226765
L&I
WA
05
—
8332090
—
WA
Enumeration date
06/29/2006
Last updated
08/09/2023
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