MR. RANDOLPH CHARLES FISH (NPI# 1063493559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063493559 |
Entity Type | Individual |
Full Name | MR. RANDOLPH CHARLES FISH |
Credential | D.P.M. |
Practice Address |
915 So. 76th St. Tacoma WA 98408-2902 |
Mailing Address |
915 So. 76th St Tacoma WA 98408-2902 |
Practice Telephone | 2535849530 |
Practice Fax Number | 3604272769 |
Mailing Telephone | 2535849530 |
Mailing Fax Number | 3604272769 |
Enumeration Date | 2005-11-10 |
Last Update Date | 2016-04-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
91-1813864 | WA | Podiatric Medicine & Surgery Service Providers |
N | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
PO00000297 | WA | Podiatric Medicine & Surgery Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WA | 2041490 | 05 | |
WA | 2041494 | 05 |
Street Address |
915 SO. 76TH ST. |
City | TACOMA |
State | WA |
Zip Code | 98408-2902 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053839597 | Michael David Clifton | Chiropractor | 1702 South 72nd Street, Tacoma, WA 98408 | 2017-09-05 |
1417405630 | Ashley Mae Grosso | Licensed Practical Nurse | 7011 S I St, Tacoma, WA 98408 | 2016-09-16 |
1568845188 | Carolyn M Jacoby | Social Worker | 4850 S Thompson Ave, Tacoma, WA 98408 | 2015-06-30 |
1265844385 | Kaitlyn Leigh Laube Ward | Podiatrist | 7808 Pacific Ave Ste 1, Tacoma, WA 98408 | 2014-05-22 |
1720315872 | Holly A Roach | Specialist | 414 So. 54th St., Tacoma, WA 98408 | 2009-11-11 |
1831328731 | Frederick Joseph Norrick Jr. | Massage Therapist | 5001 Pacific Avenue S, Integrative Body Therapeutics, Gibson Gardens Suite 422, Tacoma, WA 98408 | 2009-07-13 |
1528198264 | Susan Joline Henricksen | Massage Therapist | 6618 So L St, Tacoma, WA 98408 | 2007-03-06 |
1043364565 | Dawn Michelle Catlow | Massage Therapist | 6201 Pacific Avenue, Tacoma, WA 98408 | 2007-01-22 |
1538223227 | Joshua Bleustar | Counselor | 860 South 54th St, Tacoma, WA 98408 | 2006-12-20 |
1235291055 | Leonardo F Romero | Chiropractor | 7047 S D St., Ste. B, Tacoma, WA 98408 | 2006-12-15 |
Find all providers in zip 98408 |
Taxonomy Code | 213EP1101X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Primary Podiatric Medicine |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689732588 | Hugh James Gorey Jr. | Podiatrist | 12001 Pacific Ave S., #204, Tacoma, WA 98444-5101 | 2006-12-04 |
1205846755 | Mark A Alenick | Podiatrist | 5920 100th St Sw, Ste 11, Tacoma, WA 98499-2751 | 2006-08-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649708819 | Theresa H.t. Nguyen Pllc | Podiatrist | 17530 Ne Union Hill Rd Ste 110, Redmond, WA 98052-3340 | 2017-05-31 |
1366749095 | Rapha Clinics, Inc | Podiatrist | 1130 N 185th St Ste 202, Shoreline, WA 98133-4011 | 2011-02-15 |
1568673895 | Victoria Kovacs Penfield | Podiatrist | 15717 136th Avenue Ct E, Puyallup, WA 98374-9688 | 2007-05-25 |
1922122811 | Randall S. Fisher | Podiatrist | 8610 Eastview Ave, Everett, WA 98208-3516 | 2007-03-18 |
1134154032 | Stephen Haggard | Podiatrist | 210 27th Ave Apt F105, Milton, WA 98354-8330 | 2006-07-11 |
1265470678 | Broadway Foot & Ankle Ps | Podiatrist | 6625 W Crest View Loop Se, Snoqualmie, WA 98065-8912 | 2006-06-04 |
1982694501 | Michael Aziz Mishalanie | Podiatrist | 401 S 43rd St, Suite 110, Renton, WA 98055-5404 | 2005-10-25 |
1942206891 | Brent Barker | Podiatrist | 18007 Ne 26th St, Vancouver, WA 98684-0735 | 2005-06-24 |
1720083652 | John Yohan Joo | Podiatrist | 1130 N 185th St, Suite 200, Shoreline, WA 98133-4011 | 2005-06-16 |
1356758668 | Jerod Stanley | Podiatrist | 3525 Ensign Rd Ne Ste N, Olympia, WA 98506-5065 | 2014-07-18 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.