Healthcare Provider Details

I. General information

NPI: 1013790914
Provider Name (Legal Business Name): RANDALL JAMES KING OXFORD LMHCA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JAMES KING OXFORD

II. Dates (important events)

Enumeration Date: 08/15/2023
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3876 BRIDGE WAY N STE 202
SEATTLE WA
98103-7951
US

IV. Provider business mailing address

3814 11TH AVE W APT 26
SEATTLE WA
98119-1477
US

V. Phone/Fax

Practice location:
  • Phone: 206-681-7586
  • Fax:
Mailing address:
  • Phone: 928-300-2762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61462027
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: