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NPI Code Detail

MEDICARE: RANDY BARADI

MEDICARE: RANDY BARADI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT 00008941WA

General Provider Information

NPI Number : 1447602875
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDY BARADI
Provider Business Mailing Address
First Line : 25117 SW PARKWAY AVE STE D
Second Line :
City : WILSONVILLE
State : OR
Zip : 97070-9697
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11 W ALOHA ST
Second Line :
City : SEATTLE
State : WA
Zip : 98119-3743
Country : US
Telephone Number : 206-284-7330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2016
Last Update Date : 07/09/2016

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Directions to “ RANDY BARADI ” Practice Location

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