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General NPI Number Information
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NPI Number | 1992063945
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Entity Type | Organization
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Legal Business Name | RANDALL INC.
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Dates
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Enumeration Date | 04/27/2012
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Last Update Date | 04/27/2012
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Provider Practice Location Address
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Address Line | 19721 SCRIBER LAKE RD #D
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City | LYNNWOOD
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State | WA
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Zip | 98036
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Country | US
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Telephone | 425-775-3544
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Fax | 425-670-6502
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Provider Business Mailing Address
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Address Line | 19721 SCRIBER LAKE RD STE D
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City | LYNNWOOD
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State | WA
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Zip | 98036-6119
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Country | US
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Telephone | 425-775-3544
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Fax | 425-670-6502
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Authorized Official
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Title or Position | OWNER
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Name | DR. RANDALL G DREESSEN
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Credential | DC
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Telephone | 425-775-3544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 2221
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License Number State | WA
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