Individual
RANDOLPH BOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
21616 76TH AVE W STE 205, EDMONDS, WA 98026-7512
(425) 640-4810
(425) 640-4884
Mailing address
21616 76TH AVE W STE 205, EDMONDS, WA 98026-7512
(425) 640-4810
(425) 640-4998
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD00047603
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8483646
—
WA
Enumeration date
02/12/2007
Last updated
10/10/2007
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