Individual
DR. HAROLD HERMAN RANDECKER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1814 90TH DR SE, LAKE STEVENS, WA 98258-3791
(425) 829-0700
(253) 216-3635
Mailing address
1814 90TH DR SE, LAKE STEVENS, WA 98258-3791
(425) 829-0700
(253) 216-3635
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
14276
WA
2086S0127X
Trauma Surgery Physician
14276
WA
2086S0129X
Vascular Surgery Physician
Primary
14276
WA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
14276
WA
Other
Enumeration date
04/24/2007
Last updated
07/08/2011
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