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Individual

RANDALL EVAN MOSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2050 BARB ST, SILVERDALE, WA 98315
(360) 415-4347
Mailing address
2050 BARB ST, SILVERDALE, WA 98315
(360) 415-4347

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1125502
CA

Other

Enumeration date
10/23/2007
Last updated
10/29/2015
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